Relocation module and methods for surgical equipment

ABSTRACT

An anesthetic equipment storage and waste air management module configured to housing electronic and electromechanical surgical equipment including a system to measure and record administration of one or more IV medications or fluids for IV administration. The module can include a housing having a lower section and a tower-like upper section, wherein the lower section is configured to house unrelated waste heat-producing electronic and electromechanical surgical equipment. The module can also include a cowling that substantially confines waste heat generated by the unrelated waste heat-producing electronic and electromechanical surgical equipment, and can include a system for measuring and recording the administration of the one or more IV medications and fluids.

PRIORITY

This application is a continuation of U.S. patent application Ser. No.18/099,475, filed Jan. 20, 2023, now U.S. Pat. No. 11,666,500, which isa continuation of U.S. patent application Ser. No. 17/875,055, filedJul. 27, 2022, now issued as U.S. Pat. No. 11,583,461, which is acontinuation of U.S. patent application Ser. No. 17/697,398, filed Mar.17, 2022, now issued as U.S. Pat. No. 11,523,960, which is acontinuation of U.S. patent application Ser. No. 17/375,546, filed Jul.14, 2021 now U.S. Pat. No. 11,291,602, which is a continuation of U.S.patent application Ser. No. 17/199,722, filed Mar. 12, 2021, now U.S.patent Ser. No. 11/173,089 B2, which is a continuation of U.S. patentapplication Ser. No. 17/092,681, filed Nov. 9, 2020, now U.S. patentSer. No. 10/993,865 B2, which is a continuation of U.S. patentapplication Ser. No. 16/879,406, filed May 20, 2020, now U.S. Pat. No.10,869,800 B2, which is a continuation-in-part of U.S. patentapplication Ser. No. 16/601,924, filed Oct. 15, 2019, now U.S. Pat. No.10,702,436 B2, which is a continuation of U.S. application Ser. No.16/593,033, filed Oct. 4, 2019, now issued as U.S. Pat. No. 10,653,577,which is a continuation of U.S. patent application Ser. No. 16/364,884,filed Mar. 26, 2019, now issued as U.S. Pat. No. 10,507,153, whichclaims the benefit of priority to U.S. Provisional Patent Application62/782,901, filed Dec. 20, 2018. U.S. patent application Ser. No.16/364,884, filed Mar. 26, 2019, now issued as U.S. Pat. No. 10,507,153is also a continuation-in-part of U.S. patent application Ser. No.15/935,524, filed Mar. 26, 2018, now issued as U.S. Pat. No. 10,512,191.The disclosures of all of these applications are incorporated herein byreference in their entirety.

TECHNICAL FIELD

This document pertains generally, but not by way of limitation, tosystems and methods for improving safety in operating rooms. Inparticular, the systems and methods described herein may include but arenot limited to, anesthetic equipment storage, waste air management,cable and hose management and automated anesthetic and patientmonitoring data capture and electronic record input.

BACKGROUND

Anesthesia monitors and equipment as well as surgical equipment havebeen invented, developed and sporadically introduced into surgicalpractice over more than a century. This equipment is made by a widevariety of companies who have no incentive to coordinate with oneanother to create the most efficient operating room. Equipmentthroughout the operating room has been placed in one location oranother, generally without a plan and then decades later, is stillsitting in that unplanned location. For example, the first of theelectronic monitors used during anesthesia was the electrocardiogram(ECG or EKG), which was introduced into the operating room in the1960's. When EKGs became small enough to be placed on a shelf, gettingit off of the floor, the most available shelf space somewhat near thepatient, was above the anesthesia gas machine. As more anesthesiarelated electronic monitors were developed and introduced into practiceover the next 40 years, they were simply stacked on top of one anotheron the same shelf above the anesthesia machine. Soon it was simplytradition that dictated that vital sign patient monitors are locatedover the anesthesia machine. Eventually the independent anesthesiarelated monitors were consolidated into single units for convenience.These consolidated multifunction anesthesia monitors were still placedon the same shelf above the anesthesia machine or on a mounting bracketattached to the anesthesia machine.

Just because a shelf happens to be available does not mean that theanesthesia related monitors are ideally located. The anesthesia machineis generally located to the side of and slightly behind the anesthetist,when standing at the head end of the surgical table facing the patient.In many cases, the anesthesia machine is located behind the anesthetist.Therefore, it is axiomatic that looking at or adjusting the anesthesiarelated monitors means that the anesthetist is not looking at thepatient but rather looking away from the patient. Therefore, when thepatient is experiencing a problem and the anesthesia related monitorsare reporting confusing or adverse information, the anesthetist isfocused away from the patient.

When the anesthesia related monitors are located in their presentlocation over the anesthetic gas machine, the numerous wires, cables andhoses connecting the monitors to the patient are generally 10-12 feetlong. There is a minimum of 5 wires and 2 hoses and frequently as manyas 10 wires, cables and 2 hoses connecting the monitors to the patient.Electric patient warming blankets, mattresses and fluid warmers are alsorapidly gaining acceptance. The controller for the electric warmingproducts is generally located adjacent the anesthesia machine and the3-6 cables connecting the controller to the warming blankets andmattresses on the patient are 12-15 feet long. Cables and hoses tangledand laying on the floor are clearly a problem in the operating room,causing not only inconvenience but getting contaminated and causing atripping hazard for operating room personnel.

Cable and hose management on the surgical side of the anesthetic screen(e.g., sheet perpendicular to the table across the neck region of apatient) is also a problem that has developed haphazardly over the pastcentury. Numerous pieces of surgical equipment have been parked somewhatrandomly in the middle of the operating room, each causing anobstruction to traffic flow. Each of these pieces of equipment has apower cord or hose that lays on the floor extending to the wall outlet.Each of these pieces of equipment has one or more cables and/or hosesthat lays on the floor extending to the sterile field of the surgicaltable. Every cable and hose on the floor is a hazard for trippingoperating room personnel. Every cable and hose on the floor is anobstruction for other rolling equipment and carts and is at risk ofdamage from these carts, needing replacement.

A typical operating room (OR) has numerous alarms that monitor thepatient's vital signs during a procedure, like heart rate and bloodpressure, but the complication of multiple alarms ringingsimultaneously, and frequent false positives creates a very distractingOR environment.

The various equipment such as electrosurgical units, smoke evacuationpumps, sequential compression sleeve pumps, blood/fluid suction units,and air mattress pumps are scattered about the operating room creatingtheir own obstacles. Wherever the surgical equipment is located in theoperating room on the surgical side of the anesthesia screen, the cablesand hoses traverse to the sterile field on the surgical table by way oflaying on the floor and becoming obstacles.

Waste heat and air discharged from heater-cooler units (HCU) near thefloor can form into convection currents of rising warm air and mobilizebacteria up and into the sterile surgical field.

Flow-boundary layers of still air form next to the surgeons andanesthesia screen, preventing the downward airflow from even the bestoperating room ceiling ventilation systems from reaching the sterilefield. When the ventilation airflow slows, the airborne contaminants andbacteria have the opportunity to settle into the open wound.

In some situations, oxygen and alcohol vapors trapped under the surgicaldrape pose a burn hazard to the patient in the presence of anelectro-cautery spark.

Over the past 20 years, there has been a gradual movement to replacingpaper anesthetic records with electronic anesthetic records (EAR). Theelectronic data outputs of the patient monitors have been relativelyeasy to input into the EAR. However, the identity, dosing and timing ofIV and inhaled drug administration, IV fluid administration and oxygenand ventilation gas administration, has required manual input to the EARby way of a computer keyboard and mouse. Blood, fluid and urine outputsas well as anesthetic events have also required manual input to the EARby way of a computer keyboard and mouse.

SUMMARY

The modules, systems and methods described herein overcome variousproblems in the operating room. For example, like the cockpit of thefighter plane, the electronic monitors used during anesthesia andsurgery should be located near the patient so that the anesthetist'sfield of vision simultaneously includes: the patient, the monitors andthe surgical procedure. However, this is not the case in conventionaloperating rooms. The modules, systems and method described herein,overcome this and other problems in the operating room, creating a saferenvironment for the patient and the operating room personnel.

It would also be advantageous if the surgical support equipment andtheir cables, cords and hoses could be removed from the floor of theoperating room.

A reduction of noises and interruptions associated with alarms meant tosignal anesthesiologists, that frequently result in distractions toother OR personnel, would be beneficial.

A way of eliminating flow-boundary dead zones from obstructing theventilation airflow and thus keeping the airborne contaminants andbacteria airborne and out of the wound, would be useful to protect theopen wound from airborne contamination.

Waste heat and air discharged from heater-cooler units (HCU) near thefloor can form into convection currents of rising warm air and mobilizebacteria up and into the sterile surgical field. Similar contaminationof the sterile field with bacteria and contaminates from the floor hasbeen shown in many studies of the waste heat and air from forced-airwarming devices. The US Centers for Disease Control has warned that dueto the positive link to implant infections, “Nothing that blows airshould be in an operating theater, if possible.” and “ . . . it isimportant not to blow air in the operating theater.” Therefore, there isa need to safely manage waste heat and air from surgical equipment andmonitors in order prevent contamination of the sterile surgical field.

With regard to flammable alcohol and oxygen vapors concentrating inparticular areas of the OR, eliminating the alcohol vapors and oxygentrapped under the surgical drape would add to the fire safety of thesurgical experience.

Illustrative examples of a relocation module systematizes surgicalsafety for patients and OR personnel. In some examples, this moduledesigned to house nearly all of the operating room patient monitors andsupport equipment. Even dissimilar types of equipment that are normallykept separate from one another. In some examples, this unique module isspecially designed to fit next to and under the arm-board of thesurgical table—a location traditionally occupied by an IV pole. For thepast 100 years, this location has been a wasted “no-man's land” betweenthe anesthesia and surgical sides of the operating room. In reality, theunique space next to and under the arm-board, is truly the “prime realestate” of the entire operating room: it is immediately adjacent thepatient for optimal monitoring while simultaneously maintainingobservation of the patient and surgical procedure; equipment controlscan be conveniently accessed by both the anesthesia and surgical staff;short cables and hoses are adequate to reach the patient; and it isuniquely accessible from both the anesthesia and surgical sides of theanesthesia screen. The unique space next to and under the arm-board isthe only location in the entire operating room where cables, cords andhoses from both the anesthesia side and the sterile surgical field side,do not need to traverse the floor or even touch the floor in order toconnect to their respective monitor or patient support equipment—truly aremarkable location that has been wasted by conventional systems.

In some examples, an illustrative relocation module can house bothanesthesia related and non-anesthesia related equipment. In someexamples, the illustrative relocation module can house a variety ofnon-proprietary OR equipment such as patient vital sign monitors andelectro-surgical generators. In some examples, the module is designed toalso house newer proprietary safety equipment such as: air-free electricpatient warming, surgical smoke evacuation, waste alcohol and oxygenevacuation, evacuation of the flow-boundary dead-zones that causedisruption of the OR ventilation and the evacuation and processing ofwaste heat and air discharged from OR equipment. In some examples, thismodule may also house dissimilar equipment (e.g., unrelated toanesthesia monitoring) such as: air mattress controls and air pumps;sequential compression legging controls and air pumps; capacitivecoupling electrosurgical grounding; RFID counting and detection ofsurgical sponges; the waste blood and fluid disposal systems; and“hover” mattress inflators. Any of these devices may be stored in therelocation module together with (or without) anesthesia equipment.

In some examples, the relocation module is a specialized and optimallyshaped rack for holding and protecting the patient monitors and otherelectronic and electromechanical surgical equipment, in a uniquelocation. A location that is very different from just setting anesthesiamonitors on top of the anesthesia machine and scattering other equipmentacross the floor of the operating room.

In some examples the preferred new location is adjacent the anesthesiaside of one or the other of the out-stretched arm-boards of the surgicaltable, a location currently occupied by an IV pole on a rolling stand.In this location, the relocated monitor screens are 1-2 feet lateral tothe patient's head, allowing the anesthesia related monitors, thepatient and the surgical field to be observed by the anesthetist in asingle field of vision. In some examples, with the monitors, the patientand the surgical field to be observed by the anesthetist in a singlefield of vision, it is highly likely that the anesthetist will belooking in that direction most of the time. Because the anesthetist isnaturally looking toward the patient and monitors, a relatively brightwarning light mounted on the tower or on one of the monitors that aremounted on the tower in this field of vision and aimed at theanesthetist, may be substituted for an audible alarm. The uniquelocation of the tower on the module allows this warning light to beaimed away from the surgical field and it is therefore not distractingor even visible to the surgeon. Only if the warning light is ignored bythe anesthetist, would a backup audible alarm which is distracting tothe surgeon and OR staff be necessary.

Locating the module adjacent the arm-board has several advantages.First, that space is currently occupied by an IV pole, so it is notcurrently being used for personnel traffic. Second, the arm-board andthe anesthesia screen above the arm-board, traditionally are theseparation boundary between the anesthesia side of the operating roomand the surgical side of the operating room—essentially an empty“no-man's land” between the two sides. The raised head end of thesurgical drape that is tethered between two IV poles, creates a physicalbarrier between the anesthetist and the surgical field, is commonlyknown as the “anesthesia screen” or “ether screen.” As a “no-man'sland,” the space under the arm-board is currently unoccupied. The spaceunder the arm-board is unique in that it can be accessed from both thesurgical and the anesthesia sides of the anesthesia screen. Access tothe module from the surgical side can be from below the lower edge ofthe surgical drape hanging down over the arm board, or more convenientlyfrom the side of the module facing away from the patient, at the distalend of the arm-board. There is no other location in the operating roomthat can be simultaneously accessed from both the surgical andanesthesia staff, while maintaining the traditional boundary or“no-man's land” between the two. Therefore, this location is uniquelysuited for a module that can contain both surgical and anesthesiaequipment.

In some examples, locating the module adjacent the arm-board means thatone of the side faces of the module is facing the patient and is within24 inches of the patients' head and chest. This location close to thepatient allows for a cable and hose management system with relativelyshort cables and hoses, which are much easier to manage than long cablesand hoses. The traditional long cables and hoses that need to reach fromthe patient to the electronic monitors located on top of the anesthesiamachine by way of draping to the floor, are easily tangled, end uplaying on the floor getting contaminated and damaged. The probability ofcables becoming tangled are not linearly correlated to cable length butrather exponentially correlated with cable length. In other words,longer cables are far more likely to get tangled. Because they are anuisance to wind for storage, they are frequently left lying on thefloor or draped over a gas machine. Long cables and hoses are alsodifficult to clean.

In some examples, the side of the module facing the patient includes acable management system. In some examples the cable management systemcomprises an array of straps with snaps or Velcro fasteners to retainthe individual cables and hoses. In some examples the cable managementsystem comprises an array of hooks to retain the cables and hoses. Othercable and hose retention mechanisms are anticipated.

In some examples, the cable management system includes cables that arenaturally coiled during the process of forming (e.g., molding) the outerinsulation, somewhat like the traditional telephone cord. In someexamples, the coils of cable or hoses may be much larger diameter thanthe traditional telephone cord. Coils that are 2-5 inches in diameter,much like a “slinky” may be preferable. Coils of larger diameter mayhave superior “memory” to retain the coiled shape. Electrical insulationmaterials such as urethane and nylon also provide superior “memory”characteristics compared to the PVC coating historically used ontelephone cords.

These larger coils are easily stretched because the elongation isaccomplished primarily by the lateral movement of adjacent coils,basically elongating the tubular shape, a movement that is minimallyopposed by the “memory” of the molding process. This contrasts with anattempt to unwind each of the individual coils, a movement that ismaximally opposed by the “memory” of the molding process. This isidentical to the principals the make a “slinky” work; very easy tostretch in the direction of the coiled tube but nearly impossible tounwind an individual coil. The larger coils easily stretch laterallybetween the planes of each adjacent coil and stretch minimally in theplane of each coil.

In some examples, the coils of the cable management system are createdby extrusion molding an electrically insulating plastic sheath over thewires of the cable. In some examples, the coils of the cable managementsystem are created by extrusion molding a coil of plastic tubing andthen inserting the wires of the cable into the tubing as a secondoperation.

Each piece of equipment on the surgical side of the anesthesia screenhas traditionally been mounted on castor wheels and parked freestanding,somewhere on the floor surrounding the surgical table. In theselocations, each of these pieces of equipment require a power cord orvacuum hose that lays on the floor and extends from the individualequipment to the wall plug or outlet. Additionally, each piece ofequipment also has one or more cables and/or hoses that extend from thesterile surgical field, down to the floor, across the floor and are thenplugged into the equipment. The freestanding equipment in the middle ofthe operating room floor is an obstruction to the movement of personnel,carts and gurneys. The cords, cables and hoses laying on the floorcreate a tripping hazard for operating room personnel, and also createan obstruction to rolling carts.

In some examples, the module can solve these problems, and otherproblems as well. In some examples, the module includes a lower sectionthat can fit under the arm-board of the surgical table, utilizing thecurrently wasted space under the arm-board. In some examples, this lowersection may have a larger footprint than the tower-like upper sectionthat may be located against the anesthesia side of the arm-board. Insome examples, a bulbous-shaped lower section creates much more spaceand volume for accommodating more pieces of electronic andelectromechanical equipment—the added volume filling the unused volumeunder the arm-board.

In some examples, the bulbous lower section allows heavier equipment tobe mounted down low in the module for added stability. In some examples,the larger footprint of the bulbous lower section allows a broader basefor added stability. In some examples, it may be advantageous to mountheavier equipment near the rear of the module to balance the weight ofthe tower-like upper section that may be mounted over the front of thebulbous lower section. This prevents the tendency for the forwardmounted tower to cause forward tipping. In some examples, the module maybe suspended from the ceiling of the operating room on a “boom.”Equipment suspended from ceiling mounted booms are well-known in theoperating room.

In some examples, the rear side of the bulbous lower section may bepositioned approximately in the same plane as the surgical drape hangingdown from the surgical side of the arm-board. The surgical drapegenerally terminates 18-24 inches above the floor, allowing the rear ofthe bulbous lower section to be uniquely accessed from the surgical sideof the anesthesia screen, below the lower edge of the surgical drape. Insome examples, electrical plug-ins and hose connections for the variouspieces of surgical equipment housed in the module may be located on therear side of the bulbous lower section.

Alternately or in addition, in some examples, if the staff prefers toaccess cable and hose plug-ins at a higher, more convenient level, thecable and hose plug-ins may be positioned on the side of the modulefacing away from the patient or on the top surface of the lower section,near the side of the module facing away from the patient, since there isno surgical drape hanging down in this area.

In some examples, cables and hoses exiting the sterile surgical fieldmay uniquely be dropped off of the sterile field adjacent the anesthesiascreen. From this location, the cables and hoses drop nearly straightdown to be attached to the cable and hose plug-ins on the rear thebulbous lower section or the side of the bulbous lower section facingaway from the patient. In this unique location, there is no need for thecables and hoses to lay on the floor while traversing the distance tothe equipment. In this unique location, there is no need for the cablesand hoses to even touch the floor while traversing the distance to theequipment. This unique location next to the surgical drape and below thearm-board is the only place in the entire operating room where cablesand hoses from supporting equipment can access the sterile surgicalfield without traversing or even touching the floor of the operatingroom and creating a tripping hazard for operating room personnel.

In some examples, consolidating the surgical equipment into the modulealso eliminates the obstructions caused by that equipment when it isfree-standing in the middle of the operating room floor. It alsoeliminates the need for power cords and vacuum hoses traversing thefloor to connect the equipment to the wall outlets.

Locating electrical and electromechanical equipment under the arm-board,can subject that equipment to a potential hazard from spilled water,spilled saltwater (saline) and blood. In some examples, in order toprotect this equipment from spilled fluids, the module is substantiallycovered in a water-resistant housing or “cowling.”

For many decades, it has been an accepted axiom in the operating room;the air below the level of the surgical table is contaminated with skincells (squames) and bacteria shed from the skin of the surgicalpersonnel. These squames are shed from the skin of the operating roompersonnel into the air of the operating room. Once airborne, the squamesare pushed toward the floor and vents near the floor, by the downwardoperating room ventilation airflow.

Waste heat from surgical equipment released near the floor, for example,heater-cooler units and forced-air warming units, has been proven toform into convection currents of rising warm air. When this waste heatis released near the floor, the rising convection currents can mobilizecontaminates and bacteria that normally resident near or on the floor,up and into the sterile surgical field. If waste heat could be preventedfrom being within 4 feet of the floor where most of the airbornecontaminates are concentrated, basically the height of the surgicaltable, it is believed that infections can be reduced.

The various pieces of electronic and electromechanical equipment housedwithin the module disclosed herein can produce relatively large amountsof waste heat. The bulbous lower section of the module is placed on thefloor next to the surgical table and is below table height since it isunder the arm-board. Releasing waste heat in this location on the floornext to the surgical table may cause a risk of sterile fieldcontamination from the rising waste heat that may include squames andother contaminants. In some examples, the module may include a wasteheat management system to safely dispose of the waste heat created bythe electronic and electromechanical equipment housed within the module.

It would be difficult or even impossible to manage the uncontained wasteheat produced by electronic and electromechanical equipment mounted on asimple open rack because it can escape in any direction. In someexamples, the module can include a “cowling” covering substantially theentire outer surface. The cowling not only protects the equipment fromaccidental fluid damage but also confines the waste heat from theelectronic and electromechanical equipment mounted within the module, tothe inside of the module and cowling. In some examples, the confinedwaste heat can then be safely managed.

In some examples, the cowling cover of the module can form or support awaste heat management system. In some examples, the cowling can beprovided on an inner surface of the housing, In some examples, thecowling can be described as an insulation. In some examples, the housingcan include other types of insulation from heat and/or water. Anysuitable type of insulated housing suitable for use in a surgical fieldcan be provided.

In some examples, the module includes a tower-like upper sectionattached to the topside of the lower section. In some examples, thetower-like upper section extends substantially vertically from the topside, near the front of the lower section. In some examples, thetower-like upper section is used for mounting monitor screens and cablemanagement retentions at an easily accessible and convenient height. Insome examples, the top of the tower-like upper section, is 5 feet ormore above the operating room floor. At this height, waste heat can beexhausted from vents near the top of the tower-like upper section isvented into the operating room, well above the height of most airbornecontaminates. In contrast, if the waste heat vented low (<4 feet abovethe floor), it may mobilize airborne contaminants up and into thesterile field causing a significant infection risk.

In some examples, the cowling of the tower-like upper section serves asa chimney, containing the rising waste heat until it can be safelydischarged from outlet vents located near the top of the tower. In thiscase, air may be allowed to enter the module through inlet vents in thelower section, the air gets heated by the electronic andelectromechanical equipment in the module and then by naturalconvection, the heated air rises within the tower-like upper section andis discharged through outlet vents near the top. In some examples, afilter and fan may be added to the waste heat management system in orderto filter the waste heated air before discharging it into the operatingroom, or to filter inlet air.

In some examples, the inlet vents for the cooling air may be located inthe tower-like upper section, above the level of the airbornecontamination. At this level, the inlet air is relatively pure andtherefore there is no risk of contaminating the equipment housed withinthe module with contaminated air. In some examples, a duct may connectthe inlet vent in the tower-like upper section to the equipment space inthe lower section. The clean inlet air may be drawn into inlet ventsmounted high on the upper section and then ducted down to the equipmentthat needs cooling and then ducted back up to the tower to be dischargedat a safe height above the airborne contaminates. In some examples,ionized air filter plates may be included in the ducting to provideadded filtration of the air without added resistance to the airflow.

In some examples, a waste air management system may be included in themodule. In this case, the waste air management system may be designed tosafely process and discharge waste air that may or may not contain wasteheat. The waste air may be the by-product of equipment contained withinthe module or may be a waste product of other OR equipment, besides themonitors. An example of waste air producing equipment may include thesmoke evacuation suction; used for evacuating electrosurgical smoke andfiltering the smoke which has been shown to periodically contain virusparticles.

Waste air producing equipment can also include operating roomventilation dead zone evacuation equipment; by vacuuming the air fromthe flow-boundary dead zones that naturally forms in front of thesurgeons and anesthesia screen, the interference of the flow-boundarylayers with the operating room ventilation can be reduced. This allowsthe ventilation airflow from the ceiling to reach the wound unimpeded bya flow-boundary dead zone. When ventilation airflow is kept moving,airborne contaminates in that air are kept airborne. As long as theairborne contaminates remain airborne, they do not land in the woundwhere they can cause an infection. When the ventilation airflow slows oreven stops due to dead zone interference, gravity takes over and theairborne contaminates settle into the wound where they may causeinfections. These dead zones of non-moving air that interfere with theoperating room ventilation can be evacuated by placing vacuum hoses intothe dead zone. The evacuated air can then be processed in order tosafely discharge the air, back into the operating room. In someexamples, the ventilation dead zone evacuation system may simultaneouslyserve as the surgical smoke evacuation suction. In this case the vacuumhose does not need to be attached to the electrosurgical pencilelectrode, which many surgeons find to be cumbersome.

Waste air producing equipment can also include heater-cooler units (HCU)that produce contaminated waste heated air that needs to be processedand safely discharged. In this case, the waste heated air is a byproductof cooling the refrigeration compressor of the HCU. Forced-air warmingunits (FAW) also produce contaminated waste heated air that needs to beprocessed and safely discharged. The FAW systems exhaust waste air fromunder the surgical drape where it escapes from under the surgical tablenear the floor. In some examples, this waste heated air can be containedand vacuumed up for safe disposal. Electrosurgical units and othersurgical equipment also produce waste heated air that needs to beprocessed and safely discharged.

In some examples, the waste air management system may be used toevacuate and/or dilute the air under the surgical drape, especially nearthe patient's head, neck and chest. Alcohol from the surgical prepsolution may pool under the drapes and then evaporate providing fuel fora fire. Waste oxygen from an unrestricted oxygen supplementation systemsuch as nasal prongs may also pool under the drapes providing an oxidantfor a fire. Then, add a spark from either the electro-cautery or a laserand highly dangerous operating room fires can occur. These fires occurfar too frequently. Even the surgical drape can burn in the presence ofan oxygen-enriched environment.

In some examples, it may be advantageous to remove the air and oxygenand alcohol vapors trapped under the surgical drape. In some examples, avacuum hose may be placed near the shoulders, chest and neck of thepatient. In some examples, the proximal end of the vacuum hose may pluginto the inlet side of the waste air management system, for a convenientsource of low velocity, low pressure vacuum.

In all of the instances, the waste heated air can be vacuumed, filteredand discharged at a height that does not allow any waste heat tomobilize contaminates normally resident near the floor, up and into thesterile field. In a possibly preferred example, the air discharge can beat a height that is greater than 4 feet off of the floor.

In some examples, the waste air management system includes an air plenumcontaining an air filter. One or more air inlets allow waste air toenter the plenum from either the equipment housed in the module or fromexternal equipment sources. A fan propels the waste air through thefilter and exhausts the air from the plenum into a substantiallyvertical vent tube. In some examples, the substantially vertical venttube extends upward to a height of more than 5 feet above the floor,before discharging the processed waste air from outlet vents near thetop of the substantially vertical vent tube. In some examples,ultraviolet lights (UV) may be included in the plenum on one or bothsides of the filter. In this location, the UV radiation can kill anyliving organisms that may have been captured by the filter. In someexamples, a fabric sock-like filter may be attached to an outlet vent.The sock-like filter diffuses the air being discharged into theoperating room to avoid jets and turbulent air currents. A sock-likefilter can muffle the sound of the fan reducing OR noise created byvarious equipment cooling and smoke evacuation fans.

In some examples, the substantially vertical vent tube may be a rigidtube. In some examples the substantially vertical vent tube may traversemostly in a vertical direction but can include non-vertical portions. Insome examples, the substantially vertical vent tube may be thetower-like upper section of the module. In some examples, thesubstantially vertical vent tube is an inflatable, collapsible tube madeof fabric, plastic film or fabric laminated to or coated with a plasticfilm. In some examples, the inflatable, collapsible tube may bedisposable.

In some examples, the inflatable tube includes a substantially sealeddistal end with one or more holes in the walls of the tube to allow theair to escape but create a flow obstruction causing the pressure withinthe inflatable tube to increase. The increased pressure in theinflatable tube causes the inflatable tube to assume an erect shape. Insome examples, the erect inflatable tube extends substantiallyvertically, in order to terminate at a height of more than 5 feet abovethe floor. In some examples, the erect inflatable tube extendsdiagonally at an upward angle.

In some examples, it may be advantageous to dilute the air and oxygenand alcohol vapors trapped under the surgical drape with air. In someexamples, an air hose may be placed near the shoulders, chest and neckof the patient. In some examples, a proximal end of the air hose mayplug into a diversion from the discharge side of the waste airmanagement system, for a convenient source of low velocity, positivepressure air.

In some examples, the output of the waste air management system may bediverted into a hose that may be hooked to an inflatable “hover”mattress for moving the patient off of the surgical table at the end ofsurgery. These “hover” mattresses are known in the arts and are inflatedwith pressurized air, which is released through holes on the bottom sideof the mattress. The released air is effectively trapped under themattress forming an air cushion on which the mattress and the patienteffectively float, allowing the patient to be easily slid from the tableto the gurney.

In some examples, the fan in the waste air management system alsoconveniently provides the pressurized air for a “hover” mattress. Airmay be diverted from the outlet side of the waste air management system,into a hose that is attached to a “hover” mattress.

In some examples, the module of the instant invention may also containthe components of the anesthesia gas machine. So-called “gas machines”are relatively simple assortments of piping, valves, flow meters,vaporizers and a ventilator. These could be located within the module orattached to the module for further consolidation of equipment and forimproved access to the patient. The close proximity to the patient notonly shortens the ventilation tubing but also shortens the samplingtubing for the carbon dioxide monitor. The close proximity of theanesthesia gas machine to the patient also allows continuous observationof the patient while adjusting the gas and anesthetic flows.

In some examples, the module (e.g., 10) may include an air/oxygenblender to supply oxygen-enriched air to the patient for facemask andnasal prong delivery. This may be especially advantageous because of thevery short distance between the module and the patient's head. Adding anair/oxygen blender may also be advantageous because many of theanesthesia machines do not include these devices. In some examples, theemergency oxygen, air and nitrous oxide tanks for the anesthesia machinemay be mounted on the lower portion of the module in order to keep thecenter of gravity as low as possible. In some examples, it may beadvantageous to mount these tanks horizontally on the sides or rear ofthe lower portion of the module rather than their traditional verticalmounting orientation, in order to avoid interfering with the arm boardof the surgical table. In some examples, it may be advantageous to mountthese tanks diagonally on the sides of the lower portion of the modulerather than their traditional vertical mounting orientation, in order toavoid interfering with the arm board of the surgical table. In thiscase, a tank that is longer than the depth of the module can still beaccommodated by locating the valve of the tank at the upper end of thediagonal near the front of the module. The closed end of the tank canthus be located at the lower end of the diagonal near the rear of themodule where it fits nicely under the arm-board. In some examples, theoxygen, air and nitrous oxide hoses supplying the anesthesia machine mayadvantageously hang from the ceiling and connect to gas inlets in thetop of the upper section of the module. In this location, the gas hosesare uniquely unobtrusive to the operating room staff.

In some examples, locating the anesthesia machine in or on the moduleallows direct access for and sensors and monitors related to theanesthesia machine, to input data to the electronic anesthetic recordbeing recorded by equipment in the module.

In some examples, the shared fan, plenum, filter and discharge system ofthe waste air management system improves the efficiency, spacerequirements and cost in the operating room by consolidating multiplepieces of equipment into one. Currently, individual pieces of surgicalequipment that produce waste air and waste heat are generally located onthe floor, somewhere around the surgical table. This is exactly theworst place for this equipment to be located because the waste air andheat from this equipment is vented near the floor. The waste heat andair can then heat the contaminated air normally resident near the floor,and then carry contaminating particles and bacteria from the floor, upand into the sterile surgical field. Consolidating all the surgicalsupport equipment in the bulbous lower section of the module with asingle waste air management system eliminates waste air and heat frombeing vented near the floor, reducing the risk of airbornecontamination.

Locating that single waste air management system in the bulbous lowersection of the module and placing it under the arm-board of the surgicaltable totally removes it from all operating room traffic while providingthe shortest possible hose distance to the patient, either on thesurgical or anesthesia side of the anesthesia screen. Locating the wasteair management system under the arm-board and surgical drape alsominimizes and muffles the annoying fan noise.

Poor teamwork between anesthesia and surgery may be due to poorcommunication. For example, the anesthesia personnel may be experiencingproblems maintaining normal vital signs and this may not be communicatedquickly and clearly to the surgeon. “Yeah, the anesthesiologistmentioned his blood pressure was decreasing but I didn't realize it wasto a critical level, so I went ahead and finished the procedure.” Afailure of the surgeon to understand the situation, can result in a widevariety of complications ranging in severity from mild to fatal. In someexamples, a solution to this problem may be to mount a vital signsdisplay screen on the rear of the tower-like upper section of themodule, facing the surgeon. In this unique location viewable over thetop of the anesthesia screen, the surgeon can be constantly aware of thepatient's vital signs.

In some examples, the collection canisters for waste fluid and blood maybe conveniently mounted on the module. Mounting the canisters on themodule eliminates the need for vacuum tubing to lay on the floor whiletraversing from the wall outlet to the canister and from the surgicalfield to the canister. Optical or infrared fluid level sensors 153 maybe conveniently mounted in the module, adjacent the canister(s). In someexamples, the fluid level monitors may automatically activate ordeactivate the vacuum to a given canister, thereby automaticallyshifting the blood and fluid flow to a new canister as the previous oneis filled.

In some examples, the controls and display screens for the surgicalequipment housed in the module may be wirelessly connected to a portabledisplay screen such as an iPad or “smart tablet,” for convenient accessby the nurse anywhere in the room. This allows the surgical nurse tomonitor and control the equipment without walking across the room. Thisis convenient for the nurse and increases awareness of equipmentconditions. Staff moving around the OR kick up contaminates from thefloor into the air where they can be carried to the sterile surgicalfield by waste heat. A portable display screen minimizes surgical staffmovement in the OR which has been shown to reduce airborne contaminationand surgical site infections.

Doctors and nurses dislike record keeping and the switch to theelectronic record has made the act of record keeping more difficult andtime consuming. Entering the electronic record into the computersometime after the event occurred and the case has settled down, is notonly distracting from patient care but leads to inaccurate records. Handentered records also bypass the opportunity for the computer to add topatient safety by checking drug identities, dosages, side effects,allergies and alerting the clinician to potential problems or evenphysically stopping the drug administration. Manually entered recordsare not useful for managing drug inventories because a given medicationadministration is not tied to a specific drug bottle or syringe.Finally, the computer mouse and keyboards have been shown to becontaminated by a wide variety of infective organisms and are virtuallyimpossible to clean. Automatic anesthetic data entry to the EAR wouldimprove patient safety, improve clinician job satisfaction and improveOR inventory management.

In general, doctors and nurses are not interested in replacingthemselves and their jobs with automated drug delivery or automatedanesthesia systems. However, they may be more open to automated recordkeeping. The challenge with automated record keeping is automating thedata input that documents the numerous activities, anesthesia relatedevents, fluid, gas and medication administration that constitute ananesthetic experience or another medical situation

The second challenge in implementing an automated electronic anestheticrecord (EAR) or electronic medical record (EMR) is to force as littlechange in routine as possible onto the anesthesiologist and otherclinicians using this system. Anesthesiologists and surgeons arenotoriously tradition-bound and resistant to any changes in their “triedand true” way of doing things. Therefore, a successful automated EARmust interact seamlessly with current anesthesia practices and operatingroom workflow without causing any disruptions.

In some examples, the automated EAR of this disclosure includes a systemfor automatically measuring and recording the administration of IVmedications and fluids. The system for automatically measuring andrecording the administration of IV medications and fluids can includeone or more sensors, such as one or more of a barcode reader and an RFIDinterrogator for accurately identifying a medication or fluid for IVadministration.

The system for automatically measuring and recording the administrationof IV medications and fluids can also include one or more digitalcameras with machine vision software (“machine vision”) for accuratelymeasuring the volume of medication administered from a syringe or fluidadministered from an IV bag through a drip chamber into an IV tubing.The digital cameras with machine vision software essentially duplicatethe clinician's vision of an activity, injection of a drug from asyringe for example, without interfering in the normal activity and yetallows automatic recording of the activity in the EAR. The machinevision software can include one or more machine-readable mediums thatwhen implemented on hardware processing circuitry of the system or inelectrical communication with the system, can perform the functionsdescribed herein.

In some examples, the automated EAR of this disclosure uses machinevision to unobtrusively “observe” the flow rate of the ventilation gasflow meters and inhaled anesthetic vaporizers.

In some examples, the automated EAR of this disclosure captures inputdata from the blood and fluid collection and urine output collectionsystems of this disclosure.

In some examples, the automated EAR of this disclosure capturesanesthetic event data by capitalizing on the fact thatanesthesiologists, surgeons and nurses compulsively tend to meticulouslyfollow their routines. For example, a particular anesthesiologist mayroutinely intubate all adult male patients with an 8.0 endotracheal tubeunless there is an abnormality. Therefore, if the EAR knows who isproviding the anesthesia, knows their preferences and knows that thepatient is an adult male, the automated EAR can “automatically” enterthe intubation event into the record and will be correct more than 95%of the time. In the unusual event of a patient abnormality requiring analteration of the routine, the anesthesia provider can manually enterthe variant information to provide an accurate record. In some examples,the relative rarity of data being manually entered into the EAR allowsfor the elimination of the computer keyboard and mouse, to be replacedby an easy-to-clean touch screen display.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, which are not necessarily drawn to scale, like numeralsmay describe similar components in different views. Like numerals havingdifferent letter suffixes may represent different instances of similarcomponents. The drawings illustrate generally, by way of example, butnot by way of limitation, various examples discussed in the presentdocument. Any combination of the features shown and described in thisdisclosure, including combinations of fewer or more features is withinthe content of this disclosure. Modules, systems and methods includingindividual features described herein, without combinations of featuresas shown in the examples (for the sake of brevity), are also within thescope of this disclosure

FIG. 1 shows a perspective view of an illustrative module that caninclude storage, airflow and cord management systems, among othersystems, in accordance with at least one example.

FIG. 2 shows a perspective view of an example standard operating roomincluding a surgical table, and a patient laying on the table, inaccordance with at least one example.

FIG. 3 shows a perspective view of the example standard operating roomof FIG. 2 , including two IV poles and a surgical drape, in accordancewith at least one example.

FIG. 4 shows a perspective view of the illustrative module of FIG. 1 inan operating room, in accordance with at least one example.

FIG. 5 shows a perspective view of another example of an illustrativemodule, in accordance with at least one example.

FIG. 6 shows a perspective view of another example of an illustrativemodule, in accordance with at least one example.

FIG. 7 shows a perspective view of another example of an illustrativemodule, in accordance with at least one example.

FIG. 8 shows a side view of an illustrative example of a cable and hosemanagement system of the illustrative system of FIG. 4 , in accordancewith at least one example.

FIG. 9 shows a side view of another illustrative example of a cable andhose management system of the illustrative system of FIG. 4 , inaccordance with at least one example.

FIG. 10 shows a side view of another illustrative example of a cable andhose management system of the illustrative system of FIG. 4 , inaccordance with at least one example.

FIG. 11 shows a side view of another illustrative example of a cable andhose management system of the illustrative system of FIG. 4 , inaccordance with at least one example.

FIG. 12 shows a side view of an illustrative individual cable and hosemanagement system of FIG. 11 , in accordance with at least one example.

FIG. 13 shows a rear view of an illustrative cord of the cable and hosemanagement system of FIG. 11 , in accordance with at least one example.

FIG. 14 shows a perspective view of the illustrative system of FIG. 10with two of the cables unwound and attached to the patient, inaccordance with at least one example.

FIG. 15 shows a rear view of a storage bracket and cable of theillustrative system of FIG. 11 , in accordance with at least oneexample.

FIG. 16 shows a side view depicting internal components of anillustrative waste air management system that can be used with thesystem of FIG. 11 , in accordance with at least one example.

FIG. 17 shows a side view depicting internal components of anotherillustrative waste air management system that can be used with thesystem of FIG. 11 , in accordance with at least one example.

FIG. 18 shows a side perspective view of an illustrative moduleincluding an example vent tube, in accordance with at least one example.

FIG. 19 shows a side perspective view of another module includinganother illustrative vent tube, in accordance with at least one example.

FIG. 20 shows an illustrative waste air management system including anillustrative vacuum hose, in accordance with at least one example.

FIG. 21A shows an illustrative surgical field depicting flow-boundarydead zones, in accordance with at least one example.

FIG. 21B shows the surgical field of FIG. 21A including an illustrativeventilation optimization system for improving the flow-boundary deadzones of FIG. 21A, in accordance with at least one example.

FIG. 21C is a top view of the surgical field and the ventilationoptimization system of FIG. 21B, in accordance with at least oneexample.

FIG. 22 shows an example of an air dilution system that can be used withthe systems described herein, in accordance with at least one example.

FIG. 23 shows a surgical field viewed facing towards an anesthesiascreen from a surgical side of the screen with a surgeon positioned in asurgery performing position, and an illustrative system (e.g., any ofthe systems described herein) positioned adjacent a surgical table, inaccordance with at least one example.

FIG. 24 shows a surgical field viewed facing towards an anesthesiascreen from a surgical side of the screen with a surgeon positioned in asurgery performing position, and an illustrative system positionedadjacent a surgical table, in accordance with at least one example.

FIG. 25 shows a surgical field viewed facing towards an anesthesiascreen from a surgical side of the screen and with a surgeon positionedin a surgery performing position, and an illustrative module positionedadjacent a surgical table, in accordance with at least one example.

FIG. 26 shows a perspective view from the anesthesia side of a surgicalfield of a patient on a surgical table, and an illustrative system atleast partially disposed under an armboard of the table, in accordancewith at least one example.

FIG. 27 shows a side view of an illustrative distribution pod hangingfrom a side rail of a surgical table, in accordance with at least oneexample.

FIG. 28 shows a perspective view of an illustrative system includingfluid suction canisters, in accordance with at least one example.

FIG. 29 shows a side view of an illustrative fluid suction bag that maybe used with the systems described herein, in accordance with at leastone example.

FIG. 30 shows perspective view of an illustrative sanitizing systemincluding UV lights, in accordance with at least one example.

FIG. 31 shows a perspective view of the illustrative sanitizing systemof FIG. 30 depicting features of the UV lights, in accordance with atleast one example.

FIG. 32A shows a side view of an illustrative distribution pod notattached to a side rail, in accordance with at least one example.

FIG. 32B shows a side view of a distribution pod angled and being placedon to a side rail, in accordance with at least one example.

FIG. 32C shows a side view of a distribution pod attached to and hangingfrom a side rail, in accordance with at least one example.

FIG. 33 illustrates a system, in accordance with at least one example.

FIG. 34 illustrates a flow chart showing a technique for operating amodule, in accordance with at least one example.

FIG. 35 illustrates another flow chart showing a technique for operatinga module, in accordance with at least one example.

FIG. 36 illustrates another flow chart showing a technique for operatinga module, in accordance with at least one example.

FIG. 37 illustrates another flow chart showing a technique for operatinga module, in accordance with at least one example.

FIG. 38 illustrates another flow chart showing a technique for operatinga module, in accordance with at least one example.

FIG. 39 illustrates another flow chart showing a technique for operatinga module, in accordance with at least one example.

FIG. 40 illustrates another flow chart showing a technique for operatinga module, in accordance with at least one example.

FIG. 41 illustrates generally an example of a block diagram of a machine(e.g., of module 10) upon which any one or more of the techniques (e.g.,methodologies) discussed herein may perform in accordance with someembodiments.

FIG. 42 illustrates an isometric view of an example system forgenerating an automated electronic anesthetic record located proximateto a patient, in accordance with at least one example.

FIG. 43 illustrates a plan view of an example of preloaded syringes 200Aand 200B that can be used with the system of FIG. 42 , in accordancewith at least one example.

FIG. 44 illustrates a side view of an example medication identificationand measurement system and a syringe that can be used with the system ofFIG. 42 , to monitor drug delivery, in accordance with at least oneexample.

FIG. 45 illustrates a cross-sectional view of the medicationidentification and measurement system and a syringe (not shown incross-section) of FIG. 44 , taken along line 45-45, in accordance withat least one example.

FIG. 46 illustrates a side view of a second example medicationidentification and measurement system and a syringe that can be usedwith the system of FIG. 42 , in accordance with at least one example.

FIG. 47 illustrates a cross-sectional view of the second example of amedication identification and measurement system and the syringe (notshown in cross-section) of FIG. 46 , taken along line 47-47, inaccordance with at least one example.

FIG. 48 illustrates a side view of a third example of a medicationidentification and measurement system and a syringe that can be usedwith the system of FIG. 42 , in accordance with at least one example.

FIG. 49 illustrates a cross-sectional view of the third example of amedication identification and measurement system and the syringe (notshown in cross-section) of FIG. 48 , taken along line 49-49, inaccordance with at least one example.

FIG. 50 illustrates an example injection port cassette that can be usedwith the system of FIG. 42 , as detailed in 45, 47 and 49, in accordancewith at least one example.

FIG. 51 illustrates a side view of an example IV fluid identificationand measurement system 230 that can be used with the systems of FIG.42-49 , and injection port cassette of FIG. 50 , in accordance with atleast one example.

FIG. 52 illustrates side view of an example of a gas flow meter systemthat can be used with the system of FIG. 42 , in accordance with atleast one example.

FIG. 53 illustrates a top view of the example gas flow meter system ofFIG. 52 .

FIG. 54 illustrates a side view of an example anesthetic gas vaporizermonitoring system that can be used with the system of FIG. 42 , inaccordance with at least one example.

DETAILED DESCRIPTION

The following detailed description is exemplary in nature and is notintended to limit the scope, applicability, or configuration of theinvention in any way. Rather, the following description providespractical illustrations for implementing exemplary examples of thepresent invention. Examples of constructions, materials, dimensions, andmanufacturing processes are provided for selected elements, and allother elements employ that which is known to those of skill in the fieldof the invention. Those skilled in the art will recognize that many ofthe examples provided have suitable alternatives that can be utilized.

As described herein, operably coupled can include, but is not limitedto, any suitable coupling, such as a fluid (e.g., liquid, gas) coupling,an electrical coupling or a mechanical coupling that enables elementsdescribed herein to be coupled to each other and/or to operate togetherwith one another (e.g., function together).

In some examples, a module includes an equipment rack in a protectivehousing or “cowling.” The module can be designed to advantageously fitinto the unique location adjacent and/or under the arm-board of thesurgical table—a location currently occupied by an IV pole on a rollingstand.

An example of such a module is shown in FIG. 1 , the module 10 (andvariations of module 10) can include a system to provide any combinationof features described herein. In some examples, the module 10 caninclude features such as storage of unrelated surgical equipment,control and/or filtering airflow and waste heat, a cord managementsystem, sanitizing system, waste fluid system, air vacuum system, fluiddispensing system, display system, and a user input system and any othersystem described herein. These systems can also be provided individuallyand still provide benefits; the combinations are not required.

As shown in FIG. 2 , the standard operating room includes a surgicaltable 22 on which the patient 24 is laying. Typically, the surgicaltable 22 includes arm-boards 26 that are attached to side rails of thetable 22 and extend laterally from the table 22 at a slightly less thanperpendicular angle. The patient's arms are rested on the arm-boards 26,which help to protect the arms from nerve damage and allow convenientaccess to the IV tubing. This general configuration for surgery hasevolved over the past century and is now a firmly embedded tradition.

As shown in FIG. 3 , there are typically two IV poles 42 that arepositioned adjacent the anesthesia side of the arm-boards 26, one oneach side of the surgical table 22. Typically, the head end of thesurgical drape 32 is elevated and attached between the two IV poles 42,creating a barrier between the surgical field and the anesthesiapersonnel who are located at the head end of the surgical table 22. Thisanesthesia screen 30 is a tradition that is meant to prevent skincontaminates shed from the anesthesia providers who are not wearingsterile gowns, from contaminating the sterile field.

The standard surgical draping shown in FIG. 3 naturally leads tosurgery-related personnel and equipment being relegated to the surgicalside 36 of the anesthesia screen 30. Further, the anesthesia-relatedpersonnel and equipment are naturally relegated to the anesthesia side34 of the anesthesia screen 30.

Effectively, the anesthesia screen 30 and arm-boards 26 and the spaceunder the arm-boards 26 have evolved into a “no-man's land” separatingthe surgical side 36 from the anesthesia side 34. Except for the IV pole42 holding up the anesthesia screen 30, this “no-man's land” is totallywasted space in the modern operating room.

In some examples, as depicted throughout this disclosure, a module 10(e.g., FIG. 4 ) of this invention not only advantageously utilizes thecurrently wasted space under and adjacent the arm-board 26, but alsocapitalizes on the uniqueness of that wasted “no-man's land” floor spaceand the volume under the arm-board 26.

In some examples, the uniqueness of the space under and adjacent to thearm-board 26 includes but is not limited to the fact that it is lessthan 2 feet from the patient's head and less than 1 foot from thepatient's arm. This is the only location in the operating room fromwhich cables, wires, hoses and IV tubing do not need to traverse awalkway or lay on the floor, in order to reach the patient 24.

As shown in FIGS. 2 and 3 , typically, an anesthesia gas machine 40 islocated to the side of and slightly behind the anesthetist, who shouldbe standing at the head end of the surgical table. Wires, cables andhoses originating from patient monitors 38 must necessarily traverseacross the distance between the anesthesia gas machine 40 and thepatient 24. The wires, cables and hoses connecting the patient monitors38 to the patient 24 are generally 10-12 feet long. The wires, cablesand hoses hang to the floor, then traverse the floor and then ascend tothe patient 24 laying on the surgical table 22. It is axiomatic that 5-8monitoring cables and hoses along with 2-6 electric patient warmingcables (e.g., that are 12-15 feet long), can create a tangled messlaying on the floor.

The tangled mess of cables and hoses on the floor create not onlyconsiderable additional work for the OR staff requiring coiling andcleaning between cases, but also create a tripping hazard for the staff.Finally, cables and hoses laying on the floor of the OR are easilydamaged by rolling carts and gurneys.

However, in the example systems described herein, the close proximity ofthe space adjacent the arm-board 26 is taken advantage of to provide forshorter monitoring, warming system and equipment cables and hoses. Insome examples, this short distance to the patient eliminates the cablesand hoses from even touching the floor, much less traversing the floor.In some examples, this is accomplished by relocating the patientmonitors 38 into the module 10. However, in some examples, the monitorelectronics 38 may remain located at a distance from the surgical table22, perhaps on the anesthesia gas machine 40, with only the terminationsof the patient monitor 38 cables and hoses attached to module 10. Insome examples, the cables may be connected to the monitors located adistance away from the surgical table 22, by wireless communications orby a trunk cable.

As shown in FIG. 4 , in some examples, the module 10 can occupy a uniquespace under and adjacent to the arm-board 26. Benefits of this locationinclude but are not limited to the fact that it is less than 2 feet fromthe patient's head and less than 1 foot from the patient's arm.Additionally, a benefit of the module 10 fitting into this uniquelocation is that it is the only location in the operating room fromwhich the patient monitoring displays 38A, 38B can be viewed by theanesthetist in the same field of vision as the patient's head and thesurgical field, while standing at the head end of the surgical table 22.

This location is in sharp contrast to the current location of patientmonitor 38 mounted on the anesthesia gas machine 40 beside and behindthe anesthetist. If the anesthetist is looking sideways at the patientmonitors 38 located on the anesthesia machine 40, he or she is clearlynot simultaneously observing the patient (e.g., observing signs ofdistress or alertness on the face of the patient). Looking sideways atthe monitors 38 located on the anesthesia machine 40, as istraditionally done, is a whole different field of vision—away from thepatient, a distraction from the primary monitor: observation of thepatient.

Currently, when the patient monitors 38 audibly alarm, the anesthetist'sattention is drawn away from the patient to the monitors 38,accentuating the distraction caused by the current location of thepatient monitors 38 on the anesthesia machine 40. In some examples, themodule 10 makes it possible for the anesthetist to observe not onlypatient monitor displays 38A, 38B, the patient 24 and the surgical fieldin a single field of vision, but also an alert or alarm light 11 shiningfrom that field of vision back toward the anesthetist. In some examples,the light 11 may substitute for an audible alarm. Audible vital signalarms from the patient monitors 38 are not only distractions for thesurgical staff but significantly add to the noise in the OR. In someexamples, one or more relatively bright warning lights 11 mounted on atower 20 or on one of the patient monitors 38A, 38B that are mounted onthe tower 20 in this field of vision and advantageously aimed at theanesthetist, may be substituted for audible alarms.

In some examples, the warning or alarm light 11 may advantageously be adirectional LED that focuses its light in specific direction—toward theanesthesia provider. Mounting the one or more alarm lights 11 on thepatient monitor display 38A or 38B that is adjustably mounted on thetower 20 to provide the best viewing angle to the anesthetist, willautomatically preferentially aim the alarm light(s) 11 at theanesthetist. Lights mounted anywhere else may not aim at the anesthetistmost of the time. Even lights mounted on a display of the patientmonitor 38 would not usually be aimed at the anesthetist when thedisplay of the patient monitor 38 is located in its traditional locationon the anesthesia gas machine 40 located to the side of the anesthetist.In contrast, the location of the tower 20 (e.g., of module 10) next tothe patient with the patient monitor display 38A, 38B mounted on thetower at eye level and adjustably “aimed” at the anesthetist, uniquelyallows lights 11 mounted on the patient monitor display 38B or tower ofthe module 10 to be substituted for audible alarms. In some examples, ifthe alarm condition is severe, the light 11 may flash to increasenoticeability. The warning or alarm lights 11 may advantageously be redbut other colors including white are anticipated. In some examples, thelights 11 may be color coded, for example: patient monitor alarms may bered; IV infusion pump alarms may be orange; oxygen and ventilator alarmsmay be yellow; and miscellaneous non-critical equipment alarms such aswarming blankets, may be blue.

In some examples, when the anesthetist acknowledges the alarm light 11by pressing a button (or functionally equivalent response), the light 11may decrease in intensity. In some examples, the light 11 automaticallyturns off only when the alarm condition is resolved. In some examples,if the anesthetist fails to acknowledge the alarm light 11 by pressing abutton within a given amount of time, for example 20-30 seconds, abackup or secondary audible alarm may sound. In some examples, if theanesthetist acknowledges the alarm light 11 by pressing a button (orfunctionally equivalent response) within a given amount of time, forexample 20-30 seconds, the backup audible alarm may be muted so as notto distract the surgical staff and add to OR noise. In some examples, ifthe overhead lights in the OR have been dimmed, the alarm light 11 mayautomatically decrease in intensity so as not to be an unnecessarydistraction to the surgical staff.

The unique location of the tower 20 on the module 10 allows these one ormore warning lights 11 to be aimed away from the surgical field, whichis therefore not distracting to the surgeon. Only if the warning light11 is not noticed or ignored by the anesthetist, would a backup audiblealarm which is distracting to the surgeon and OR staff be necessary.

In some examples, the patient monitors and monitor display screens 38A,38B may be located on the module 10 next to the patient. In someexamples, the patient monitor display screens 38A, 38B may be located onthe module 10 next to the patient, while the monitor electronics 38C mayremain mounted to the anesthetic gas machine 40 or elsewhere (e.g., FIG.4 ). In this instance, the output of the patient monitors 300A, 300B maybe wirelessly transmitted to at least one patient monitor displayscreens 38A, 38B mounted on module 10, for convenient viewing. In someexamples, the patient monitor display 38A, 38B can include a smalldigital LCD projector or equivalent electronic projector may be mountedon the module 10 or on an articulating mount connected to module 10,next to the patient. From this location, the projector may be used toproject vital signs and other monitor information on to the anesthesiascreen 30, or another screen substantially above the patient's head.Alternately in some examples, a small projection screen may fold downfrom the module 10 and unfurl the projection screen adjacent andparallel to the anesthesia screen 30 substantially above the patient'shead. Vital sign information projected on to the anesthesia screen 30 orsmall projection screen optimizes the simultaneous visualization of thepatient and the monitors, in a single field of vision—much like apilot's “heads-up” display.

As shown in FIG. 4 , in some examples the rear side 50 of the module 10is roughly in the same vertical plane (or a plane parallel to orsubstantially parallel to) as the surgical drape 32 hanging down fromthe arm-board 26, when the module 10 is located under the arm-board 26.In this unique location, wires, cables and hoses can exit the sterilesurgical field adjacent the surgical side 36 of the anesthesia screen 30and drop substantially downward to be plugged into electrical plug-insand air inlet vents 86 located on the rear side 50 of the module 10. Thewires, cables and hoses do not even have to touch the floor at thatlocation. However, even if they do touch the floor, they do not crossany location where a surgeon would be standing, nor do they cross anywalking pathway. In this unique location adjacent the surgical side 36of the arm-board 26, even wires, cables and hoses that are on the floordo not create a tripping hazard or an obstacle for small wheels. In someexamples, a half pipe-shaped cable and hose cradle may be attached nearthe lower edge of the rear side 50 of the module 10. Cables and hosesdraping from the surgical field to the rear side 50 of module 10 maysafely elevated off of the floor by laying in this half pipe-shapedcradle 51. Locating module 10 adjacent to and under the arm-board 26,allows this unique and safe access for wires, cables and hoses from thesterile surgical field.

In some examples, it may be preferable to locate the wire and cableplug-ins and the hose inlet vents 86 on the side 48 of the module 10facing away from the patient. On this side, the electrical plug-ins andhose inlet vents 86 can be located higher on the module 10 for moreconvenient access by staff. When the plug-ins and connectors are locatedon the side 48 of the module 10 facing away from the patient, it ispossible that the wires, cable and hoses may lay on the floor at therear 50 of the module 10 and then rise to connect with the plug-ins andconnectors. However, wires, cables and hoses laying on the floordirectly adjacent to the rear side 50 of the module 10, which is locatedunder the arm-board 26 and surgical drape 32, will not create anobstacle for standing or walking.

The inlet vents 86 can be located on any suitable surface of the module10, including under the bottom of the module 10 in order to collect airfrom near the floor. The inlet vents can include a flapper door or othersuitable movable sealing device so that the vent stays closed unless ahose is plugged into the inlet vent 86.

The equipment location illustrated in FIG. 4 is unique in the entireoperating room from the perspective of safe wire, cable and hosemanagement, exiting the surgical field. All other locations for surgicalsupport equipment require that wires, cables and hoses exit the surgicalfield and traverse the floor between the surgical table 22 and theequipment. As a result, this creates a tripping hazard for personnel andobstacle for small wheels.

As shown in FIG. 4 , in some examples the rear side 50 of tower-likeupper section 18 is directly adjacent the anesthesia screen 30. Theanesthesia screen 30 can include a sheet that separates the sterilesurgical field from the non-sterile anesthesia work area. This exactlocation is uniquely the closest non-sterile location to the sterilesurgical field. Nowhere else around the surgical table is any piece ofnon-sterile equipment this close to the sterile surgical field. In someexamples the rear side 50 of the upper section 18 may be taller than theupper edge of the anesthesia screen 30, therefore it is visible from oraccessible from the surgical side, over the top of the anesthesia screen30. Since the rear side 50 of the upper section 18 may be directlyadjacent the anesthesia screen 30, it does not create any newflow-boundary layer obstructions to the ventilation airflow.

In some examples the rear side 50 of the upper section 18 is taller thanthe upper edge 31 of the anesthesia screen 30. Therefore, the rear side50 of the upper section 18 can be uniquely situated to mount variouspieces of equipment that may be useful for the surgeon. For example, asshown in FIG. 23 , one or more surgical monitor screens 138 such as:patient vital sign monitor screens, surgical scope monitor screens,surgical check list monitor screens, safety check list monitor screens,communications and message monitor screens, clocks and timing devicescreens. In some examples the rear side of the upper section 18 may beuniquely useful for mounting a fan or surgical lights aiming at thesurgical field.

As shown in the illustrative module 2310 of FIG. 23 , in some examples,a fan 134A or 134B is positioned to blow air from the head end of thesterile surgical field to the foot end. It is well known that moving airkeeps suspended particles suspended. In contrast, suspended particlessettle out of suspension in still, non-moving air. The ventilationairflow in the region between the surgeons standing on each side of thesurgical table is frequently obstructed due to flow-boundary layersadjacent the surgeon's bodies (e.g., FIG. 21A). Therefore, theventilation airflow is prevented from flowing which allows airbornecontaminating particles to settle into a surgical wound 114. An airflowcreated by the fan 134A or 134B at the head end of the sterile field canprevent or reduce the air between the surgeons from becoming still andthus allowing settling.

A traditional surgical light is shaped like a disc and is generallyabout 24-36 inches in diameter. As shown in FIG. 23 , in someembodiments, a surgical light 135 of this disclosure may be shaped likea ring with a hole 139 passing through its middle and individual lights137 located around the ring. The hole 139 in the middle of the light 135may allow the ventilation airflow from the ceiling to pass through thesurgical light 135. Air passing through the middle of the ring-shapedlight 134 eliminates the dead zone of no airflow that typically formsunder flow obstructing disc-shaped surgical lights.

In some examples, the fan 134A or 134B can be located at the head end ofthe sterile field. The fan 134A may be mounted in the hole passingthrough the ring-shaped light. From this location, the airflow from thefan 134A may advantageously be aimed at the surgical wound when thelight is aimed at the surgical wound 114 (FIGS. 21A, 21C).

As shown in the illustrative module 2410 of FIG. 24 , in some examples,the rear side 50 of the upper section 18 may be uniquely useful formounting articulating arms that can “reach” across the upper edge of theanesthesia screen 30, into the sterile surgical field and hold surgicallights, surgical instruments, surgical scopes or surgical retractors.Locating module 10 directly adjacent the anesthesia screen 30 uniquelyallows access to the surgical field from the head end of the surgicaltable. Mounting surgical lights, surgical instruments, surgical scopesor surgical retractors to articulating arms that are attached to therear side 50 of the upper section 18 obviates the need for attachment ofthis equipment to the side rails of the surgical table. This isespecially useful because mounting the articulating arms to the siderail of the surgical table is difficult or even impossible when thepatient and the side rail is fully covered by a surgical drape. In someexamples, the articulating arms that can “reach” across the upper edgeof the anesthesia screen 30 may be covered by custom sterile plasticdrapes to prevent contamination of the sterile field. “Reaching” overthe top (e.g., upper edge 31) of the anesthesia screen both avoids theneed for the side rail mounting and uniquely provides access to thesurgery from the head end.

In some examples the rear side 50 of the upper section 18 is taller thanthe upper edge 31 of the anesthesia screen 30 and may be used as a mountone or more video cameras for recording the surgical procedure for:training and education purposes, inter operating room communication,communication with the family in the waiting room or video documentationfor liability avoidance (much like police body cameras). In someexamples a video camera mounted on the rear side 50 of the upper section18 can show its image on one of the patient monitor display screens 38A,38B, so that the anesthetist can view the surgical procedure withoutstanding next to the anesthesia screen 30 and thus avoiding thedisruption of the ventilation airflow caused by standing next to theanesthesia screen 30. A view of the surgical procedure on the patientmonitor display screens 38A, 38B would both improve the anesthetists'situational awareness and reduce airborne contamination of the sterilesurgical field.

In some examples as shown in FIG. 25 , the rear side 50 of the uppersection 18 may be taller than the upper edge 31 of the anesthesia screen30 and may include a mount for a sterile storage container 132 forsurgical supplies. The sterile storage container 132 may be accesseddirectly from the sterile field, reducing the time that the surgicalteam must wait for various sterile supplies. Negating the need for thecirculating nurse to approach the sterile surgical field to deliver thatgiven sterile supply also avoids the nurse kicking up contaminates offof the floor or disrupting the ventilation airflow during the supplydelivery.

In some examples, as shown in FIG. 4 , the module 10 can include 4 ormore sides (e.g., regions, side portions, faces). When positioned in theunique “no-man's land” under and adjacent the arm-board 26, two of thesides 48 and 50 of module 10 are naturally available for surgical staffaccess and surgical equipment connections. In this position, two of thesides 44 and 46 of module 10 are naturally available for anesthesiastaff access and anesthesia equipment connections. There is no otherlocation in the operating room that can be advantageously “shared” byboth anesthesia and surgery (two teams that do not historically sharevery well).

In some examples, the front face 44 of module 10 is substantially facingthe anesthesia provider. Therefore, the front face 44 may naturallyinclude controls and displays 38A, 38B for the anesthesia monitors andequipment. The front face 44 may also include plug-ins for certainequipment such as a heated clinician warming vest or specialty monitors.In some examples, the front face 44 includes a keyboard 56 and mouse padfor data entry. Other equipment such as IV bag pressurizers, IV pumpsand drug infusion pumps may also be mounted on the front face 44 forconvenient access by the anesthetist.

In some examples, the patient monitor display 38A, 38B and/or keyboard56 (or other user input) may be mounted on swiveling brackets that allowside-to-side and/or up and down adjustment for improved viewing angles.In some examples, the patient monitor display 38A, 38B may be mounted onbrackets that swing into a position even closer to the patient (lateralto the centered midpoint of the module 10). From this unique location,the anesthetist has a very clear view of the monitor displays 38A, 38Bin the same field of vision as the patient's head and the surgicalfield. No other monitor display 38A, 38B mounting location in theoperating room can provide this simultaneous visual access to both themonitors 38A, 38B and the patient 24. With the monitor display (e.g.,screen) “aiming” at the anesthetist, an alarm light attached to themonitor display will also aim directly at the anesthetist, assuring thatit will be noticed.

In some examples, the side 46 of the module 10 facing the patient 24(e.g., as viewed in FIGS. 8-11, 14 and 26 ), can advantageously be usedfor its close proximity to the patient 24. In some examples, wire, cableand hose management may be located on the side 46 facing the patient 24(e.g. patient side of the module, patient face of the module). Most ofthese cables and hoses are for anesthesia purposes, including but notlimited to electronic patient monitors, end-tidal carbon dioxidesampling, automated blood pressure monitors, electrically heatedblankets and mattresses and waste oxygen scavenging and dilution.

In some examples, cables and hoses for surgical equipment may beadvantageously managed from the side 46 of the module 10 facing thepatient 24. Examples include but are not limited to air mattresses,pressure sensing mats, sequential compression leggings, capacitivecoupling electrosurgical grounding electrodes and RFID antennae fordetecting retained surgical items.

In some examples, the module 10 also includes a hanger 144 for holdingand securing a urine bag 140 off of the floor. In some examples, and asshown in FIG. 26 , the urine bag hanger 144 may be advantageouslymounted on side 46 of the bulbous lower section 16 facing the patient24. From this position, the urine bag tubing 142 can easily reach themodule 10 from the sterile field or from under the surgical table,without traversing or touching the floor. From this position, the urinebag 140 can conveniently be accessed by the anesthetist from the frontface 44 of the module. In some examples, the urine bag hanger 144 caninclude a hook-like element. In some examples, other urine bag hanger144 elements including but not limited to, clips, straps, snaps orVelcro, or any other suitable attachment mechanism may be provided

In some examples, the urine bag hanger 144 is attached to a scale 145for measuring the weight of the urine bag 140 plus the weight of theurine in the bag. Measuring the weight of the urine is far more accuratethan the traditional method of visually measuring the volume of urine ina collapsible plastic urine bag 140. Since urine has virtually the samespecific gravity as water, each 1 gram of urine weight equates to 1 mlof urine volume.

In some examples, the urine bag hanger 144 is attached to an electronicscale 145 for measuring the weight of the urine bag 140 plus the urinein the bag. In some examples, the digital output of the electronic scale145 that is attached to urine bag hanger 144 is directly reported on apatient monitor display 38A or 38B. In some examples, the electronicoutput of the electronic scale 145 that is attached to urine bag hanger144 (e.g., generated sensor data) is digitalized and received by theprocessor that is programed to record the beginning weight of the urinebag (the weight of the urine bag plus any urine already in the bag) andautomatically subtract that beginning weight from subsequent recordedurine bag weights, calculate the urine output during surgery. In someexamples, the electronic output of the electronic scale 145 is digitizedand reported (e.g., generated and a signal sent) to a processor (e.g.,processing circuitry 157) In some examples, the total urine output andin some cases urine output per hour determined by the processor, arethen displayed on a patient monitor display 38A or 38B. In someexamples, the total urine output and in some cases urine output per hourdetermined by the processor, may be automatically recorded in theelectronic anesthetic record, a non-transitory computer readable medium.Including an electronic scale attached to urine bag hanger 144conveniently obviates the need to empty the urine bag 140 at thebeginning of the operation in order to “zero” the system, as istraditional with a visual urine measuring system. The electronic scale145 allows the beginning weight of the urine bag plus any urine alreadyin the bag to be easily subtracted from the running weight (e.g., Theprocessor can calculate a zero point). Time measurements do not need tobe limited to per hour measurements, any unit of time, such as perminute, or per second, may be used. In some examples, a urinemeasurement per surgery can be displayed or saved.

To perform determinations and calculations and take action, theprocessor can receive and processor signals (including sensor data andother input data) and can generate signals that are communicated to acontroller that is operably coupled to the processor. The controller caninclude one or more control modules, for example electronic controlmodules (ECMs), electronic control units (ECUs) and the like. The one ormore control modules may include processing units, memory, sensorinterfaces, and/or control signal interfaces for receiving andtransmitting signals. The processor may represent one or more logicand/or processing components used by the control module to performcertain communications, control, and/or diagnostic functions. Forexample, the processing components may be adapted to execute routinginformation among devices within and/or external to the control module.

In some examples, the urine bag 140 may include an inlet near its topfor attaching a vacuum or suction hose from the module 10. In someexamples, a hydrophobic, air-permeable membrane may be added to theproximal end of the urine bag tubing 142, near the patient's catheter.Introducing a mild vacuum in the urine bag 140 pulls air through thehydrophobic, air-permeable membrane into the urine bag tubing 142. Theresulting air bubble in the urine bag tubing 142 near the patient end ofthe tubing, is pulled to the urine bag 140 by the vacuum. The moving airbubble breaks any air “vapor locks” that may have formed in the urinebag tubing 142 and that may be obstructing the flow of urine through theurine bag tubing 142, allowing free flow of the urine into the urine bag140.

In some examples, and as shown in FIG. 4 , the rear side 50 of themodule 10 is open to the surgical side 36 of the anesthesia screen 30,below the surgical drape 32 hanging down from the arm-board 26. Fromthis location, the rear side 50 can be accessed directly for plugging inwires, cables and hoses exiting the sterile surgical field. However, thelow height of the access, below the lower edge of the surgical drape,may be considered to be inconvenient.

In some examples, the side 48 of module 10 facing away from the patient24 may be advantageously accessed by the surgical nurse withoutencroaching on the anesthetist, the anesthetist's space or theanesthesia side 34 of the anesthesia screen 30. In some examples, theside 48 facing away from the patient 24 may include the controls anddisplay screens 120 for surgical equipment (e.g., surgical supportequipment) contained within the module 10. This surgical equipmentincludes but is not limited to: an electrosurgical unit, an airmattress, a pressure sensing mat, a smoke evacuation unit, a dead-zoneevacuation system, blood and fluid suction and disposal, sequentialcompression leggings and an RFID surgical sponge and instrument countingand detection system.

In some examples, most of the surgical support equipment may beincorporated into module 10, which allows the surgical nurse ortechnician to monitor and control all of this equipment from a singlelocation—the side 48 of the module 10 facing away from the patient 24.The consolidated surgical equipment controls and displays 120 becomevery efficient for the nurse to monitor compared to having the equipmentscattered all over the operating room. This is also far more likely thatproblems will be noticed early than if the individual pieces ofequipment are scattered all over the operating room as is the currentpractice. Efficient monitoring also means that patient safety isimproved. In some examples, the displays and controls 120 for thesurgical equipment may be located on the front face 44 of the module 10,or another face of the module.

In some examples, the controls and display screens for the surgicalequipment housed in the module 10 may be wirelessly connected to aportable display screen such as an iPad or “smart tablet,” forconvenient access by the nurse anywhere in the room. This allows thesurgical nurse to monitor and control the equipment without walkingacross the room. Minimizing surgical staff movement in the OR has beenshown to reduce airborne contamination and surgical site infectionsbecause less contaminates are “kicked up” by walking around the OR.

In this unique location adjacent the arm-board 26, the various sides 44,46, 48, 50 of module 10 are naturally and advantageously adapted fordifferent functions. The rear side 50 and the side 48 facing away fromthe patient can be adapted for surgical purposes. The front side 44 andthe side 46 facing the patient can be adapted for anesthesia purposes.The only place that this unique combination could be achieved is in thecurrently unoccupied “no-man's land” between the anesthesia 34 andsurgical sides 36 of the operating room—the anesthesia screen 30 andarm-board 26. The module 10 is uniquely adapted to advantageously fitthis location.

As described herein, sides (e.g., faces) 44, 46, 48, 50 can be distinctsides as in the planar sides of a rectangular cuboid shape, or anothercuboid shape. In some examples, the faces can include any shapeincluding non-cuboid shapes having more than 4 outward facing sidesaccessible to medical personnel.

However, in other examples the sides can refer to side portions of acurved or irregular shaped volume. In some examples, the sides can referto an approximately 90 degree or quarter span of the volume that formsthe module 10.

In some examples, as shown in FIGS. 4-7 , the module 10 includes a lowersection 14 and an upper section 18. In general, the lower section 14 maycontain the heavier equipment such as one or more power supplies 212,the electro-surgical unit and monitor electronics. In general, the uppersection 18 may contain lighter equipment and components such as ducting,fans, filters, cable management systems, wiring harnesses and monitoringscreens 38A, 38B. Keeping the heavy equipment in the lower section 14improves the stability and reduces the risk of tipping.

In some examples, and as shown in FIGS. 4-6 , the lower section 14 couldbe called a bulbous lower section 16. “Bulbous” is compared to the uppersection 18. There are several advantages for the lower section 16 being“bulbous.” The bulbous lower section 16 has an increased internal volumethat can house much more equipment. The bulbous lower section 16efficiently utilizes the otherwise wasted space under the arm-board 26.The bulbous lower section 16 substantially increases the footprint ofthe base of module 10, allowing the rear wheels to be much further tothe rear of the module, substantially increasing the stability of themodule 10. Heavier equipment may be located toward the rear of thebulbous lower section 16, which further increases the stability andlessens the likelihood of module 10 tipping forward.

In some examples, the bulbous lower section 16 may be of any size. Insome examples, a cube roughly 24 inches on each side can fit under thearm-board 26. Other sizes and shapes are anticipated. A 24 inch cube mayappear to be rather large and cumbersome, but it is worth noting thatthe standard 5-wheeled base for an IV pole 42 is an area roughly 24inches in diameter. Therefore, the floor occupied by and the trafficpatterns affected by the 24 inch square of the bulbous lower section 16,is virtually identical to the 24 inch diameter circle of the current IVpole 42 that can sometimes be located in that same position. However,the volume above an IV pole base is wasted in contrast to the bulbouslower section 16 which may include 8 cubic feet or more, of volume thatcan house various surgical and anesthetic equipment. The bulbous lowersection 16 very efficiently utilizes otherwise wasted volume under andadjacent to the arm-board 26. In some examples the bulbous lower sectionmay include between 4 and 12 cubic feet of volume. In a possibly morepreferred example, the bulbous lower section 16 may include between 6and 10 cubic feet of volume.

In some examples, the bulbous lower section 16 may include standardized19″ electronic component racks. In this case, the modular electronic andelectromechanical components stored in the bulbous lower section 16 canbe easily added or removed. For the standardized 19″ electroniccomponent rack systems to work, the various pieces of electronic andelectromechanical anesthesia and surgical equipment to be relocated intothe module 10, will need to be reconfigured to fit the standardized 19″electronic component rack.

In some examples, the module 10 may be additionally stabilized andprevented from tipping by suctioning the module to the floor of the OR.The floors of most ORs are very smooth and polished, with no crevassesthat can collect contaminates. This creates an ideal surface forcreating a vacuum in a suction cup. In some examples, instead of or inconjunction with wheels 52, one or more suction cups 53, much like thesuction cups for handling large glass panes, may be extended downwardfrom the bottom of module 10 to engage with the floor. In some examples,when the module 10 has been positioned properly, one or more actuatorpneumatic cylinders or electromechanical mechanisms may be triggered tolower the one or more suction cups 53 until they contact the floor. Insome examples, the actuator can be a hand-powered or manually actuatedactuator. In some examples the actuator can be electronically controlledby processing circuitry receiving instructions from an indictor such asa switch or touch screen element. A vacuum is then applied to the one ormore suction cups 53. The vacuum can be applied, for example, by thehospital vacuum system or from a vacuum pump located within the module10. When the module 10 is suctioned to the floor, it will exhibitsignificantly more stability and be less likely to tip or move than asimilar module left freestanding. In other words, the suction cups cancreate a suction coupling with the floor.

The vacuum can be applied to the suction cups at a discrete point intime, intermittently or continuously. In the suction cups that are forhandling large glass panes, the vacuum is generally created with asingle discrete lever action. In contrast, in some examples, the vacuumin the present disclosure may be continuously applied by connecting thesuction cup to the hospital vacuum system or the vacuum system in module10. A continuous vacuum supply may be advantageous over a single vacuumapplication when there is dust, lint or dirt on the floor that may foulthe seal of the suction cup, making it leak air and slowly lose itsvacuum. A continuous vacuum supply can overcome a slow air leak. Todecouple the module 10 from the floor, the vacuum can be released andthe suction cups elevated off of the floor by the one or more actuatorpneumatic cylinders, electromechanical mechanisms or hand-poweredactuators, before the module 10 can be moved.

In some examples, as shown in FIG. 7 , the lower section 14 may not bebulbous. In some examples, the lower section 14 may be designed to fitadjacent the arm-board 26 but may not go under the arm-board 26. In someexamples, the lower section 14 may fit minimally under the arm-board 26.In this instance, the space under the arm-board 26 may be utilized forstability by adding short legs 54 extending rearward to mount castorwheels further rearward. Even if the volume under the arm-board 26 isnot utilized for equipment storage, the volume adjacent the arm-board 26may be efficiently utilized for storing equipment in the lower section14 of the module 10.

In some examples, the module 10 of can include a shell or “cowling” 12covering substantially the entire outer surface. Open equipment rackswith various pieces of equipment stacked on their shelves that remainopen and exposed must be kept at a safe distance from the surgical table22. In contrast, creating an enclosed module 10 for storing variousunrelated pieces of equipment is unique in the operating room. Creatingan enclosed module 10 for storing various unrelated pieces of equipmentmakes it possible to place the module 10 near the surgical table 22during a surgery. The cowling 12 can protect the equipment in the module10 from accidental fluid damage by IV fluids, irrigation fluids andblood. Any equipment on an open rack adjacent and under the arm-board26, may be at high risk for damage from water, saltwater and blood inthis hazardous environment.

In some examples, the cowling 12 of module 10 is made of molded plastic,3-D printed plastic, molded fiberglass, aluminum, steel or othersuitable materials. In some examples, the cowling 12 may preferably befluid resistant if not fluid proof. In some examples, the cowling 12 canbe shaped so that water naturally runs off of it and that it has smoothsurfaces for easy cleaning. In some examples, any air inlet vents caninclude overhangs that protect them from fluid ingress from spilledfluids and the access ports of the cowling 12 may preferably be sealedwhen closed, to prevent fluid ingress.

In some examples, the cowling 12 of module 10 confines the waste heatfrom the electronic and electromechanical equipment mounted within themodule 10, to the inside of the module 10 and cowling 12. In someexamples, the confined waste heat can then be safely managed. Confiningwaste heat from unrelated equipment can be the first step in safelymanaging the waste heat. Waste heat can only be confined and capturedfor processing if there is a relatively air-impermeable cowling 12surrounding the equipment. It is difficult or even impossible to managethe unconfined waste heat produced by electronic and electromechanicalequipment mounted on a simple open rack or free-standing in the middleof the operating room floor.

In some examples, the cowling cover of the module 10 described hereincontributes to a waste heat management system. The cowling 12 cansubstantially seal in the waste heat and control the discharge of thewaste heat to exit at a predetermined location, such as an outlet vent.In some examples as shown at least in FIGS. 1, 4 and 7-12 , the module10 can include a tower-like upper section 20 attached to or integrallyformed with the topside of the lower section 14. In some examples, thetower-like upper section 20 extends substantially vertically from thetopside, near the front of the lower section 14. In some examples, thecowling 12 of the tower-like upper section 20 serves as a chimney,containing the rising waste heat until it can be safely discharged fromoutlet vents located near the top of the tower.

In some examples, the top of the tower-like upper section 20 is 5 feetor more above the operating room floor. At this height, waste heatexhausted from vents near the top of the tower-like upper section 20 isvented into the operating room well above the height of most airbornecontaminates. In some examples, air is allowed to enter the module 10through inlet vents 86 (FIGS. 4, 16, 17 ) in the lower section 14, theair gets heated by the electronic and electromechanical equipment in themodule 10 and then by natural convection, the heated air may rise withinthe tower-like upper section 20 and be discharged through outlet ventsnear the top of module 10.

In some examples, the air discharge can occur at a height between 3 and12 feet above the floor that the module 10 is configured to rest on. Ina preferred example, the air discharge can occur at a height of at least4 feet off the floor. In a more preferred example, the air discharge canoccur at a height of at least 5 feet off the floor. In some examples,the air discharge can be connected to an OR venting system which removesthe discharged air from the OR.

In some examples, a filter and fan may be added to the waste heatmanagement system in order to filter the waste heated air beforedischarging it into the operating room, or to filter inlet air. Theresistance to airflow caused by adding a filter to the airflow path maynecessitate adding a fan to the waste heat management system. In someexamples, a sock-like filter may be added to the outlet vent in order todiffuse the outlet air and muffle any fan noise.

In some examples, the inlet vents for the cooling air may be located inthe tower-like upper section 20, four or more feet above the floor,above the level of the airborne contamination. At this level, the inletair is relatively pure and therefore there is no risk of contaminatedair causing contamination of the equipment housed within the module 10.In some examples, a duct may connect the inlet vent in the tower-likeupper section 20 to the equipment space in the lower section 14. Theclean inlet air can be drawn into inlet vents mounted high on the uppersection 18 and then ducted down to the equipment that needs cooling andthen ducted back up to the tower 20 to be discharged at a safe heightabove the airborne contaminates. In some examples, ionized air filterplates may be included in the ducting to provide added filtration of theair without added resistance to the airflow.

In some examples, the lower section 14 includes castor wheels 52. Thecastor wheels 52 may be located substantially in the four corners of thelower section 14. In some examples, the lower section may include morethan 4 castor wheels. In some examples, and as shown in FIG. 7 , thelower section 14 may include short “legs” 54 that stick 2-10 inches outfrom the perimeter of the base of the lower section 14. Castor wheels 52may be attached near the distal ends of these short legs 54 to improvethe stability of the module 10.

In some examples, the module 10 does not have wheels but is rathermounted to a movable boom hanging from the ceiling of the operatingroom. The boom can include two or more arms that articulate and areattached to a pivot point on the ceiling. This configuration allows themodule 10 which is attached to the end of the boom, to be moved into aposition adjacent the arm-board 26 and then moved away from thatposition, if for example a gurney needs to be placed against the side ofthe surgical table. In some examples, even the boom-mounted modules 10advantageously include bulbous lower sections 16 to maximally capitalizeon the wasted volume under the arm-board 26. In some examples, boomsfrom the ceiling may advantageously include power cords, communicationcables, air, oxygen and vacuum hoses that conveniently connect outletsin the ceiling to the module 10.

In some examples, the module 10 includes an upper section 18 as shown inFIGS. 4-7 . In general, the upper section 18 is for housing or mountinglighter equipment and locating controls 120 and monitor displays 38A,38B at a height where they can be conveniently accessed. In someexamples, the upper section 18 may be a tower-like upper section 20 asshown in FIGS. 4 and 7 . In this instance the top of the tower-likeupper section 20 may be more than 4 feet above the floor. In someexamples, the top of the tower-like upper section 20 may advantageouslybe 6 feet or more above the floor.

Using the example modules 10 described herein, heat and air can be moresafely discharged at higher heights in the operating room because theheat discharged at that height cannot mobilize contaminates thatnormally reside near the floor. Therefore, a taller tower-like uppersection 20 may advantageous.

In some examples, a patient monitor display 38A, 38B may be mounted onthe rear of the tower-like upper section 20 of the module 10, facing thesurgeon. In this unique location, viewable over the top of theanesthesia screen 30, the surgeon 108 can be constantly aware of thepatient's vital signs.

In some examples, the upper section 18 of module 610 may be a mediumheight, for example 3-4 feet above the floor as shown in FIG. 6 . Insome examples, the upper section 20 may be a relatively low height of2-3 feet above the floor as shown in FIG. 5 . In each case, the uppersection 18 places the controls 120 and monitor displays 38A, 38B for theequipment can be enclosed in the module 510 or 610, at a more convenientheight for the operator. FIG. 5 also illustrates a tank 214 disposed in(or on) the module 610. Illustrative tank 214 can supply any of theanesthesia gasses, pressurized air or vacuum etc., as described herein.

In some examples, patient monitor display screens 38A, 38B may bemounted on one or more sides (e.g., faces, side portions) of the uppersection 18 of module 10 as shown in FIGS. 4 and 7 . In some examples,the patient monitor display screens 38A, 38B may be mounted on arms thatattach to the top of the upper section 18 as shown in FIG. 6 . In someexamples, a keyboard 56 and/or mouse pad may also be mounted to theupper section 18 of module 10 (FIG. 4 ).

In some examples, upper section 18 includes a side 46 facing thepatient. In some examples, if the upper section 18 is tower-like, theside 46 facing the patient is a relatively large surface area. Forexample, the side 46 facing the patient may be 12 inches wide (or more)and 48 inches tall (or more) which results in 4 square feet of surfacearea on the side 46 of the upper section 18. This large surface near thepatient and facing the patient is uniquely located and sized for a cableand hose management system 58.

In some examples, and as shown in illustrative module 810 of FIG. 8 ,the cable and hose management system 58 may comprise one or more straps70 mounted on the side 46 facing the patient (e.g., configured to facethe patient, configured to face the surgical table). In some examples,there may be an array of 3-15 straps 70. Each strap 70 may retain anindividual cable or hose. These straps 70 may include a snap, Velcro orother closures means 72 in order to create an openable loop that canretain a coiled cable or hose.

In some examples, as shown in illustrative module 910 of FIG. 9 , thecable and hose management system 58 may comprise one or more hooks 74mounted on the side 46 facing the patient. In some examples, there maybe an array of 3-15 hooks 74. Each hook 74 may retain an individualcable or hose.

In some examples, as shown in illustrative module 1010 of FIG. 10 , thecable and hose management system 58 may comprise one or more reels 76mounted on the side 46 facing the patient. In some examples, there maybe an array of 3-15 reels 76. Each reel 76 may retain an individualcable or hose. These reels 76 may be used to wind the cables and hoseson to a spool for secure storage. The reels 76 may be manually operated,spring powered or powered by electric motors.

In some examples, and as shown in illustrative module 1110 in FIG. 11 ,the cable management system can include cables that are naturally coiledduring the molding process of the outer insulation, somewhat like thetraditional telephone cord. In some examples, the coils 60 of cable orhose may be much larger than the traditional telephone cord. As shown inFIGS. 12 and 13 , coils 60 that are 2-5 inches in diameter, much like a“slinky” may be preferable. Coils 60 of larger diameter may havesuperior “memory” to retain the coiled shape. Electrical insulationmaterials such as urethane and nylon also provide superior “memory”characteristics compared to the PVC coating historically used fortelephone cords.

As shown in FIG. 14 , these larger coils 60 are easily stretched becausethe elongation is accomplished primarily by the lateral movement ofadjacent coils, perpendicular to the plane of the individual coils,basically elongating the tubular shape, a movement that is minimallyopposed by the “memory” of the molding process. This is in contrast toan attempt to unwind each of the individual coils 60, a movement that ismaximally opposed by the “memory” of the molding process. The largercoils 60 easily stretch laterally between each adjacent coil 60 andstretch minimally in the plane of each coil 60. This is identical to theprincipals the make a “slinky” work, very easy to stretch in thedirection of the coiled tube but nearly impossible to unwind anindividual coil. The larger coils 60 easily stretch laterally betweeneach adjacent coil 60 which makes them far less prone to twisting andtangling than if an individual coil 60 is “unwound.”

In some examples the coils 60 of the cable management system 58 arecreated by extrusion molding an electrically insulating plastic sheathover the wires of the cable. In some examples the coils 60 of the cablemanagement system 58 are created by extrusion molding a coil of plastictubing 80 and then inserting the wires of the cable 78 into the tubing80 as a second operation. In some examples, when tubing 80 is used tocreate the coils 60, the tubing 80 may be 0.25-0.6 inches in outsidediameter. Larger tubing 80 diameters may work better with larger coil 60diameters. In some examples the preferred tubing material is urethane.Any other suitable tubing materials may be used, including but notlimited to nylon and PVC.

There are several advantages to adding a cable 78 to a molded coil 60 ofplastic tubing 80 as a second process rather than molding the insulationlayer of the cable into a coiled shape. The extruded tubing 80 has athicker outer layer of very uniform extrusion thickness, which resultsin a more durable outer layer with superior memory for the coiled shape60. The diameter of the tubing 80 may be significantly greater than anequivalent diameter of extruded cable insulation. The greater diameterof the tubing 80 accentuates the principle that makes a “slinky” work,very easy to stretch in the direction of the coiled tube but difficultto unwind an individual coil 60.

In some examples, one construction is to add 0.5-4 feet of standardcable 78 to the distal end of the coiled tubing 80 and pull theindividual wires through the coiled tubing 80 to the proximal end of thetubing 80. In this case, the distal 0.5-4 feet may be a much moreflexible cable 78 than the coiled tubing 80 because the cable 78 is notintended to retain a memory for a coiled shape. The tubing 80 and thecable 78 may be made of different materials, or different durometers ofthe same material, or different stiffness's of the same material fortheir outer insulation layers, each of which optimize the intendedfunction (coil memory vs. flexibility). The wall thickness of the tubing80 can also be adjusted to optimize coil memory vs. flexibility.

The 0.5-4 feet of standard cable 78 attached to the distal end of thecoiled tubing 80 also presents a lower profile as it encounters thepatient. For example, if the cable 78 is an EKG lead laying on top ofthe patient's chest, a flexible non-coiled wire or cable 78 can be morecomfortable than coiled tubing 80.

In some examples, this design optimizes the recoil function at theproximal coiled tubing 80 portion of the cable. This design alsooptimizes the patient interface for flexibility, low profile and comfortby transitioning from the coiled tubing 80 to a standard cable 78 forthe distal 0.5-4 feet.

In some examples as shown in FIGS. 12 and 13 , the proximal end 62 ofthe proximal coil 60 is firmly attached to the side 46 of the module(e.g., 1110, FIG. 11 ) facing the patient, in order to prevent thetubing 80 from twisting when removed from the storage bracket 66. Insome examples, the firm non-twisting attachment may preferably orientthe plane of the first coil 60 and thus the planes of all of the coils60, essentially parallel to the plane of side 46. Orientation of thefirst coil 60 to be parallel to the plane of side 46 makes the entirestack of coils 60 naturally form into a tubular or stack shape for easystorage. In some examples, a storage bracket 66 protrudes from the side46 to provide a storage location for the naturally coiled tubing 80cables and hoses. The natural coiled shape makes loading the tubularstack of coils 60 onto the storage bracket 66 so easy that it almostoccurs spontaneously.

In some examples as shown in FIGS. 12, 13 and 15 , the storage bracket66 may include a retaining lip 68 that helps to prevent the coils 60from inadvertently slipping off of the storage bracket 66. In someexamples as shown in FIG. 15 , the retaining lip 68 may alsoadvantageously allow one or more individual coils 60 to be removed fromthe storage bracket 66 while retaining the remaining coils 60. Thisconveniently allows variable lengths of tubing, cables and hoses to beextended from the cable and hose management system 58. Cables and hosesthat need to reach further, for example to the foot of the surgicaltable or to the arm-board on the opposite side of the surgical table,may require all of the coils 60 to be removed from the storage bracket66 and stretched to their limits. Alternately, if a given cable or hoseis only traveling a short distance, for example to the patient's chestor the head end of the mattress, perhaps only one or two individualcoils 60 may be removed from storage bracket 66 and the remaining coils60 are retained on the bracket 66. This minimizes the excess cable andhose from cluttering and tangling.

In some examples, with minimal force six, 3-inch diameter coils 60 ofthis invention can be stretched perpendicularly to the plane of theindividual coils 60, a distance of more than 4 feet. In the stretchedconfiguration, the coils 60 may preferably still exhibit recoil forcesbut the recoil forces are not so great as to pull the plug or sensor 82loose from the patient connection.

The recoil of the molded coils 60 naturally cause the adjacentindividual coils 60 to form into an orderly stack or tubular shape whichcan easily be loaded onto the storage bracket 66. Storing the stack ofindividual coils 60 on a storage bracket 66 helps the individual coils60 and the stack of coils 60 “rest” and thus may retain their molded“memory” for a coiled shape over years of use.

In some examples, the natural recoil of the coils 60 can advantageouslyprevent the electrical plug 82 or hose connector from touching the floorwhen not loaded on the storage bracket 66 and not in use. The naturalrecoil of the coils 60 may advantageously prevent the plug 82 or hoseconnector from touching the floor even if the coiled tubing 80, cable 78or hose is not properly stored on the storage bracket 66. Keeping cables78 and hoses off of the floor vastly reduces their contamination andneed for cleaning. This is in contrast to the current cable and hosesituation in the OR, where they typically lay on the floor when not inuse.

In some examples the cable and hose management system 58 using coiledtubing 80 may be adapted to a location that is remote to the module 10.In some examples the cable and hose management system 58 using coiledtubing 80 may be adapted to the outer shell or case of another piece ofequipment such as a patient warming system or a patient monitor.

In some examples, and as shown in FIGS. 27 , the cable and hosemanagement system 58 (e.g., FIGS. 8-15 ), rather than being included inmodule (e.g., 10 and example variants of 10), may be adapted to be afree-standing distribution pod 146A that may be attached to the side ofthe surgical table 22 and may be used to distribute and connect thedistal end of the wires contained in a trunk cable 148, to the patient24 and surgical table 22. In some examples the cable and hose managementsystem 58 adapted to a free-standing distribution pod 146A includescoiled cables 60, coiled tubing 80, cables 78, mounting and storagebrackets 66 previously described that may be advantageously used tostore the cables and hoses for various surgical and anesthetic equipmentand monitors in a convenient location immediately adjacent the patient(e.g., FIGS. 8-15 ). Attaching the free-standing distribution pod 146Ato the side rail of the surgical table 22, locates the pod 146A as closeto the patient as possible keeping cable and hose lengths reaching tothe patient as short as physically possible. Short hoses and cablesresult in less tangling, less chance of laying on the floor and areeasier to clean and store.

In some examples the cable and hose management system 58 adapted to afree-standing distribution pod 146A, is attached to one end of a trunkcable 148 and the other end of the trunk cable may be attached to anyelectronic or electrical equipment including but not limited to: themodule 10, a patient warming controller, a patient monitor, air mattresscontrols, an electrosurgical generator, an automated blood pressuremonitor or sequential compression legging controls. The trunk cablecombines all of the wires from the individual cables into a singlemulti-wire cable in order to reduce the number of wires that can tangleand require cleaning.

In some examples, the free-standing distribution pod 146A includes asubstantially waterproof shell 150. In some examples the distributionpod 146A, like the module 10, can include a fluid-resistant or heatconfining cowling. In addition to the trunk cable 148, the inputs andoutputs to the shell 150 of distribution pod 146A include but are notlimited to: coiled cables 60, coiled tubing 80, cables 78, electricalplug-ins 152, air hose and vacuum hose connectors. In some examples, thefree-standing distribution pod 146A may include air pumps, vacuum pumpsand monitor electronics housed in the shell 150.

In some examples, the free-standing distribution pod 146A may beattached to the proximal end of a second trunk cable, the distal end ofwhich may be attached to a second free-standing distribution pod (e.g.,a second one of 146A). In effect, the two distribution pods 146A may be“daisy chained” together via the second trunk cable and in this case thefirst trunk cable 148 includes the combined wires for both distributionpods 146A, connecting back to the originating electronic and electricalequipment. In some examples for example, the second free-standingdistribution pod 146A may distribute the cables and hoses that connectthe patient to the patient monitors. In this case the firstfree-standing distribution pod 146A may distribute the cables connectingthe patient warming blankets and mattresses to the patient warmingcontroller. The second trunk cable may also include electrical power tothe second free-standing distribution pod 146A for powering variouselectronics and pumps that may be housed within its shell 150.

In some examples, the free-standing distribution pod 146A or otherpieces of surgical equipment, may be removably attached to one of therails 174 that run along the sides of the surgical table 22. FIG. 32Ashows another example of a distribution pod 146B that can include allthe features of distribution pod 146A and vice-versa. As shown in FIG.32A, the attachment mechanism for removably attaching the distributionpod 146B to one of the rails 174 may comprise a metal plate 176, mountedon the back side of the distribution pod 146B. The upper edge 178 of themetal plate 176 may be bent into a generally “hooked” shape for hangingon the side rail 174. In some examples, the upper edge 178 may beattached to a “side rail” element that is included in the module 10.

In some examples, and as shown in FIG. 32A, the generally “hooked” shapeof the upper edge 178 of the metal plate 176 may be formed by bendingthe metal plate 176 twice. In some examples, the first bend 180 in metalplate 176, nearest the mounting to the back side of the distribution pod146B or other pieces of surgical equipment, may create a first angle 194of greater than 90° between the metal plate 176 and the top of the“hook” 184. In some examples, the first bend 180 in metal plate 176,nearest the mounting to the back side of the distribution pod 146B orother pieces of surgical equipment, may create an angle of 95° to 135°between the metal plate 176 and the top of the “hook” 184. In someexamples, the second bend 182 in metal plate 176 creates the retaininglip portion 186 of the generally “hooked” shape 184, may create a secondangle 196 of approximately 90° between the top of the “hook” 184 and theretaining lip portion 186. In some examples, the distance between firstbend 180 in metal plate 176 and the second bend 182 as measured on theinside of the “hook” 184, may be equal or slightly more than the widthof the rail 174. The standard width of rail 174 is ⅜″.

In some examples, one or more retainer tabs 188 are located slightlymore than one rail height below the first bend 180 in metal plate 176.The standard height of rail 174 is 1⅛″. The retainer tabs 188 may beformed by bending the metal plate 176 along a vertical axis. In someexamples, the retainer tabs 188 may be located near the lateral edges ofmetal plate 176. In some examples, the retainer tab 188 may be formed bywelding or attaching an added piece of metal to protrude from the backside of metal plate 176.

In some examples, the first bend 180 creating an angle of greater than90° between the metal plate 176 and the top of the “hook” 184 and thesecond bend 182 creating an angle of approximately 90° between the topof the “hook” 184 and the retaining lip portion 186, allows theretaining lip portion 186 to be angled outward relative to the plane ofmetal plate 176. As shown in FIG. 32B, the outward angle of theretaining lip portion 186 allows the bottom portion of the distributionpod 146B or other pieces of surgical equipment to be pivoted away fromthe side of the surgical table 22 while the retaining lip portion 186initially engages rail 174. In this orientation one or more retainertabs 188 clear the outer side of rail 174 while the rail 174 is engagingthe “hook” 184. As shown in FIG. 32C, the bottom portion of thedistribution pod 146B or other pieces of surgical equipment are thenrotated toward the side of the surgical table 22, engaging retainer tabs188 under the rail 174. The snug fit of retainer tabs 188 under the rail174 secures the distribution pod 146B or other pieces of surgicalequipment to the rail 174. The snug fit of retainer tabs 188 under therail 174 is allowed because the first bend 180 creates an angle ofgreater than 90° between the metal plate 176 and the top of the “hook”184, and becomes the axis of rotation against the upper, outer angle 190of rail 174, when the distribution pod 146B or other pieces of surgicalequipment are rotated toward the side of the surgical table, engagingretainer tabs 188 under the rail 174. Therefore, the distance betweenthe first bend 180 and the top of the retainer tabs 188 can be exactlythe height of the rail 174, in order to create a snug fit betweenretainer tabs 188 underside of rail 174.

In contrast, when both the first bend 180 and the second bend 182 createangles of approximately 90°, the distance between the bends have to bemuch greater than the width of the rail 174 in order to allowdistribution pod 146B or other pieces of surgical equipment to be angledaway from the side of the surgical table, allowing retainer tabs 188 toclear the outer side of rail 174, while the rail 174 is engaging the“hook” 184 during mounting. Additionally, when both the first bend 180and the second bend 182 created angles of approximately 90°, the axis ofrotation during the rotation of the distribution pod 146B or otherpieces of surgical equipment toward the side of the surgical table 22,would be somewhere between first bend 180 and the second bend 182 andthe axis of rotation would against the upper, inner angle 192 of rail174. In this arrangement, the first bend 180 has to be elevated off theupper surface of rail 174 when the distribution pod 146B or other piecesof surgical equipment are rotated away from the side of the surgicaltable 22. With this unfavorable axis of rotation, the distance betweenthe first bend 180 and the top of the retainer tabs 188 may have to besignificantly greater than the height of the rail 174, in order forretainer tabs 188 to rotate under the rail 174. When the distancebetween the first bend 180 and the top of the retainer tabs 188 issignificantly greater than the height of the rail 174, the retainer tabs188 can fail to snuggly and securely attach the distribution pod 146B orother pieces of surgical equipment to the rail 174.

In some examples, the simple but secure attachment of the distributionpod 146B or other pieces of surgical equipment to rail 174, can preventaccidental detachment, falling and damage to the equipment. Detachmentof the distribution pod 146B or other pieces of surgical equipment fromrail 174 is accomplished by rotating the bottom portion of thedistribution pod 146B or other pieces of surgical equipment outward,away from the side of the surgical table 22, which disengages theretainer tabs 188 from under the rail 174. Then lifting the distributionpod 146B to disengage the “hook” 184 from the rail 174.

Traditionally, electric power cords, air hoses, oxygen hoses, vacuumhoses and communications wires hanging from the ceiling of the OR,disrupt workflow and create hazards to personnel movement when nothooked to their intended equipment. Traditionally, electric power cords,air hoses, oxygen hoses, vacuum hoses and communications wires hangingfrom the ceiling of the OR are limited in length so as to not touch thefloor when hanging free. This limited length severely limits themovement and flexibility of location for the anesthesia gas machine orany other any other equipment to which they may be hooked. The gasmachine must be located directly below the ceiling outlets. In someexamples, power cords, communication cables, air, oxygen and vacuumhoses from the ceiling can be more safely and unobtrusively connected tothe top of a taller tower-like upper section 20.

In some examples, power cords, air hoses, oxygen hoses, vacuum hoses andcommunications wires are coiled similarly to coils of the cablemanagement system 58 disclosed herein. In some examples, the coils arecreated by extrusion molding a coil of plastic tubing and then insertingthe wires of the cable or cord into the tubing as a second operation. Insome examples, the coils are created by extrusion molding a coil ofplastic tubing for air hoses, oxygen hoses and vacuum hoses. In someexamples, the coiled plastic tubing portion comprises the proximal endof the cable or hose, the end attached to the ceiling. The coiled tubingmay be any length but may preferably be 6-16 feet when stretched in someexamples.

In some examples, nylon may be the preferred material for the coiledtubing because of its superior springiness and memory, however, anysuitable material may be used. The coiled portion allows the cables andhoses to be stretched and elongated, which greatly increases the floorarea where the given OR equipment may be located, increasing theflexibility of the OR layout. The stretchable tubing also decreases thenumber of ceiling connection locations that are necessary to provideconnection options for the whole OR.

In some examples, a “tail” portion (e.g., like 78 in FIG. 12 ) ofrelatively straight, relatively flexible cord, cable, tubing or hose isattached to the distal end of the coiled tubing hanging near theceiling. In some examples, the transition between the coiled portion andthe tail portion does not require the connection of two dissimilarmaterials. In some examples, the coiled tubing may be simply bestraightened in a heating process that relaxes the memory of the coil.In this case the coiled portion and the tail portion are the proximaland distal ends of the same piece of tubing. In some examples, the tailportion hangs down to a level that can be reasonably reached by a personstanding on the floor, and yet not hang down far enough to hit ORpersonnel in the head when not attached to equipment. In some examples,the distal end of the tail portion terminates approximately 7 feet abovethe floor. The coiled portion allows the stretched cables and hoses torecoil when not hooked to equipment, thus naturally lifting the distalconnectors up to a level that can protect OR personnel from being hit inthe head. The relatively straight tail portion reduces visual clutterhanging from the ceiling and reduces the chances of adjacent cables andhoses tangling when connected to a given piece of equipment.

In some examples, the coiled cords, cables, tubing or hoses may beattached near the distal end of a light-weight arm that can rotatearound an axis near its proximal end. The proximal end of the arm can beattached to the ceiling at the axis. The supply lines for the cords,cables, tubing or hoses emerge from the ceiling near the axis and thenrun toward the distal end of the arm where they hook to the coiledcords, cables, tubing or hoses that can be pulled down and attached tothe module 10. The rotation of the arm around its axis creates an arcthat covers a large area of the ceiling and allows significantflexibility in where the coiled cords, cables, tubing or hoses mayconveniently hang down to be attached to the module 10 or other surgicalequipment.

Waste air is currently discharged from every piece of electrical andelectromechanical surgical and anesthesia equipment in the operatingroom. The discharged air is simply blown into the operating room,usually near the floor where the given piece of equipment is located.Waste heat and air discharged near the floor has been shown to form intorising convection currents of heated air that can carry infectiouscontaminates from the floor up and into the sterile surgical field.Waste heat vented near the floor is a dangerous surgical infection risk.Contaminated waste air blowing from heater-cooler units has beengenetically linked to heart valve infections.

The problem is that all electronic and electromechanical equipmentproduce waste heat that must be dissipated, or the equipment can bedamaged. Typically, this is accomplished with a cooling fan that simplydischarges the waste heat and waste air into the operating room.Additionally, some pieces of surgical and anesthesia equipment such asforced-air warming, produce heated air on purpose and then it becomesheated waste air. The waste air and heat from forced-air warming cancause contamination of the sterile surgical field and cause implantinfections. Discharging waste heated air into the operating room,especially close to the surgical table and sterile field, is dangerousbecause it causes contamination of the sterile filed which has beenlinked to implant infections, especially joint implant infections.Therefore, this waste air and heat should be vacuumed, processed andsafely discharged in order to prevent sterile surgical fieldcontamination and catastrophic implant infections.

In other examples, the vacuumed air from the surgical field such assurgical smoke evacuation or ventilation dead-zone evacuation or wasteoxygen and alcohol evacuation, must also be processed and safelydischarged.

In some examples, and as shown in illustrative module 1610 of FIGS. 16and 17 , the modules 1610 and 1710 can include a waste air managementsystem 84. The waste air management system 84 may include an inlet vent86 with a connector 88 that can connect to one or more vacuum hoses 90(FIG. 20, 22 ) designed to vacuum waste air from a specific location. Insome examples, where more than one inlet vent 86 is provided (e.g., 86,86B-86H, it may be advantageous to have the various air and vacuum hoses90 connected (e.g., operably couplable) to the waste air managementsystem 84 by way of “keyed” connections 88 (FIG. 20, 22 ) so that theyare not mistakenly attached to the wrong inlet 86, 86B-86H. For example,the hose connection 88 may be any other shape than the traditional roundshape, for example: triangular, square, five or six sided, oval, diamondshaped or any other shape. In some examples, the inlet vents 86, 86B-86Hon the waste air management system 84 and the connectors 88 on thespecific vacuum hose 90 may be color coded for easy identification.

In some examples, the waste air management system 84 includes an airplenum 92 containing an air filter 94. The filter 94 may advantageouslybe a HEPA (99.97% efficient) or “near HEPA” filter. The one or more airinlet vents 86, 86B-86H can allow waste air to enter the plenum 92 fromeither the equipment housed in the module 1610 or from externalequipment sources. As previously described, a flapper door could beprovided at the inlet vents 86 into the housing or into the plenum inorder to keep the inlet vents 86 closed unless being used. In someexamples, a low filtration efficiency pre-filter may be placed near theinlet vents 86 in order to prevent organic contaminates such as airbornebody fluids, bone or tissue fragments, from entering and contaminatingthe interior of the waste air management system 84.

In some examples, plenum 92 may contain a particle ionizer that may belocated in the airflow path before the filter 94. The particle ionizeradds electrical charges to the suspended particles in the airflow path,causing them to stick together and become larger. Larger particles areeasier to capture in the filter 94 and thus the filtration efficiency ofthe entire waste air management system 84 is improved. In many cases,adding electrical charges to bacteria also results in killing thebacteria.

In some examples, inlet vents 86 may be purposefully located near thefloor or even facing the floor and located under the module 10. When thewaste air management system 84 has excess capacity compared to theamount of air being vacuumed from the surgical field and needed forequipment cooling, inlet vents 86 located near the floor may be openedto allow the intake of contaminated air from near the floor. Forexample, when the vacuum created by the fan 96 is greater than aspecified amount, inlet vents near the floor automatically open up(either electronically or mechanically) to evacuate contaminated airfrom under the table so that when the surgeon is standing next to thetable and moves around, the surgeon doesn't stir up particles.

The contaminated air from near the floor can then be filtered by thewaste air management system 84 and discharged as clean air back into theoperating room. In so doing, the waste air management system 84 uses itsexcess air cleaning capacity to decrease the total number of airbornecontaminating particles in the OR and thus reducing the risk of surgicalimplant infections. This is particularly advantageous because it isuniquely vacuuming and filtering the contaminated air from near thefloor adjacent the surgical table that has the highest probability ofreaching the sterile surgical field.

In some examples, a fan 96 (e.g., any suitable blower) can propel wasteair received via inlet vents 86 through the filter 94 and exhaust thewaste air from the plenum 92 into a substantially vertical vent tube 98.In some examples, the substantially vertical vent tube 98 extends upwardto a height of more than 5 feet above the floor, before discharging theprocessed waste air from outlet vents 100 near the top of thesubstantially vertical vent tube 98. In some examples, a sock-likefilter may be added to the outlet vent 100 in order to diffuse theoutlet air and muffle any fan noise. In some examples, the vertical venttube can be any shaped channel configured to guide the flow of air. Insome examples the vertical vent tube includes directing air morevertically than horizontally with respect to a ground the module isconfigured to be paced on. In some examples, the vertical vent tube canbe linear, angled, bent or curved portions or can be solely linear,angled, bent or curved, such that discharging the waste air upward isachieved.

In some examples, the inlet vent 86 is attached to an air plenum 92located in the module 1610. The air plenum 92 can be designed to directinlet air through a filter 94 and fan 96 before safely discharging itinto the operating room. In some examples, the filter 94 is located inthe airflow path before the fan 96 so that the air contacting the fan 96has already been cleaned by the filter 94. Contaminated air has beenshown to contaminate fans, which are very difficult to clean and mayaerosolize contaminates into the discharged air. In some examples, thefan 96 may be located between the air inlet vent 86 and the filter 94.In some examples, all of the ducting and plenums of the waste airmanagement system 84, are accessible on their internal surfaces forcleaning and decontamination.

In some examples, the filtered waste air is then directed throughducting 102 which functions as a substantially vertical vent tube 98, upthe tower-like upper section 20, to be vented 100 out near the top ofthe tower-like upper section 20. In some examples, the filtered wasteair is then directed through the cowling 12 of the tower-like uppersection 20 which functions as a substantially vertical vent tube 98, tobe vented out 100 near the top of the tower-like upper section 20. Insome examples, a sock-like filter may be added to the outlet vent 100 inorder to diffuse the outlet air and muffle any fan noise.

In some examples, the substantially vertical vent tube 98 may be a rigidtube. In some examples, the substantially vertical vent tube 98 may bethe tower-like upper section 20 of the module (e.g., 1610 and 1710).

In some examples, and as shown in illustrative modules 1810 and 1910 ofFIGS. 18 and 19 , the substantially vertical vent tube 98 can be aninflatable, collapsible tube 104 made of fabric, plastic film or fabriclaminated to or coated with a plastic film. In some examples, theinflatable, collapsible tube 104 may be disposable. In some examples,the distal end 106 of the inflatable, collapsible tube 104 is made ofwoven or non-woven fabric that serves both as a flow obstruction toincrease the pressure in the tube and also as a final filter before thewaste air is discharged.

In some examples, and as shown in FIGS. 18 and 19 , the inflatable,collapsible tube 104 includes a substantially sealed distal end 106 withone or more holes in the walls of the tube to allow the air to escapebut create a flow obstruction causing the pressure within theinflatable, collapsible tube 104 to increase. The increased pressure inthe inflatable tube 104 causes the inflatable tube 104 to assume anerect shape. In some examples as shown in FIG. 18 , the erectinflatable, collapsible tube 104 extends substantially vertically inorder to terminate at a height of more than 5 feet above the floor. Insome examples as shown in FIG. 19 , the erect inflatable tube 104extends diagonally at an upward angle. Depending on the direction of theangled portion, the distal top end 106 of the inflatable tube 104 may bepositioned outside of the operating room ventilation flow field foradded safety.

In some examples, the waste air management system 84 produces arelatively high-volume airflow (10-100 CFM) at relatively low positiveand negative (vacuum) pressures (less than 2 inches of water). Thisallows the fan 96 in the lower section 14 to operate at relatively slowspeeds under normal conditions in order to minimize the fan noise. Thelarge volume of the bulbous lower section 16 of the module 10advantageously allows the fan 96 of the waste air management system 84to be relatively large in diameter. Large diameter fans may produce highvolume airflows with relatively slow fans speeds. In some examples, thewaste air management system 84 includes noise cancelation or activenoise control electronics (e.g., noise canceling device 210. Noisecancelation technologies work by generating a sound waves that are in aninverted phase or antiphase to the sound waves of the noise to becancelled. When the antiphase waves are superimposed on each other, theycancel each other out through destructive interference. Noisecancellation is particularly effective in cancelling repetitious soundssuch as fan noise. The noise-canceling device 210 may be located in themodule 10 or within the air-flow pathway or both (FIG. 4 ).

In some examples, the waste air management system 84 may safely processthe waste air that is the by-product of equipment contained within themodule 10. In some examples, inlet vents 86 into the plenum 92 are influid connection with the interior space of module 10. Waste heated airthat has cooled the equipment in the module 10, may be vacuumed from theequipment space into the plenum 92 for safe processing and discharge.

In some examples, the waste air management system 84 may safely processthe waste air that is the by-product of other surgical and anesthesiaequipment. Waste air producing surgical equipment includes Heater-coolerunits (HCU) that produce contaminated waste heated air that needs to beprocessed and safely discharged. In this case, the waste heated air is aby-product of cooling the refrigeration compressor of the HCU that hasbeen contaminated by water leaking from the water chiller. Forced-airwarming units (FAW) also produce contaminated waste heated air thatneeds to be processed and safely discharged. The FAW systems exhaustwaste air from under the surgical drape where it may escape from underthe surgical table near the floor. In some examples, this waste heatedair from FAW can be contained and vacuumed up for safe disposal.Electrosurgical units and other surgical equipment also produce wasteheated air that needs to be processed and safely discharged.Conventionally, these various pieces of equipment in the operating roomare not stored proximate one another in a module 10 (e.g., moduleincluding a cowl or seal) with a common waste air management system 84.Anesthesia monitoring is generally located in the non-sterile anesthesiafield, while the surgical focused equipment is located distal from theanesthesia monitors.

In some examples, a vacuum hose 90 may terminate near or in the wasteheat and waste air producing equipment. In some examples, it may beadvantageous to attach a collection “funnel” to the end of the vacuumhose in order to direct the waste air into the hose end. In someexamples as shown in illustrative module 2010 of FIG. 20 , the funnel122 may be a rigid construction if it is gathering air from the outletvent of a specific piece of equipment such as a heater-cooler unit. Insome examples, the funnel 122 may be a flexible construction, forexample a sheet of plastic film, if it is gathering air from thedischarge area of a forced-air warming blanket. In some examples, theperimeter of the sheet of plastic film may be adhesively bonded to theopen end of the underside of a FAW blanket.

In some examples, the vacuum hose 90 for the evacuation of waste airfrom surgical and anesthesia equipment may be lightweight, thin walled,inexpensive hose, ½-2 inches in diameter. The vacuum hose 90 mayadvantageously be made of polyethylene, polypropylene, PVC or otherplastic materials. The vacuum hose 90 may advantageously be corrugated.In some examples, the proximal end of the vacuum hose 90 for theevacuation of waste air from surgical and anesthesia equipment is auniquely shaped connector 88 such as square or triangular for example.

In some examples, the waste air management system 84 may safely processthe waste air and smoke that is the by-product of the electro-cauteryused for tissue cutting and coagulation. This smoke has been shown to bea hazard to the surgical staff because it may contain carcinogens andmay contain viruses.

As shown in FIGS. 21A, in some examples, a smoke evacuation suctionsystem used for evacuating electrosurgical smoke may include a hose 90hooked to a vacuum source. The distal end of the hose 90 may be locatednear the surgical wound that is being cauterized or tissue being cutwith electro-cautery. The distal end of the hose 90 may be attached tothe active electrode of the electro-cautery or it may be located nearthe surgical wound. If it is located near the surgical wound, the distalend 116 of the hose 90 may be secured to the sterile surgical drape withan adhesive element 130A, 130B. Any other suitable securing method, suchas, but not limited, to clips and ties may also be provided.

In some examples, the proximal end connector 88 (e.g., FIG. 22 of thesmoke evacuation hose 90 for smoke evacuation from the surgical field,may be attached to the inlet vent 86 of the waste air management system84. The smoke from the electro-cautery may be safely vacuumed from thesurgical field and then filtered in the waste air management system 84.In some examples, the hose 90 for smoke evacuation may be lightweight,thin walled, inexpensive hose, ⅜-¾ inches in diameter. The tubing mayadvantageously be made of polyethylene, polypropylene, PVC or otherplastic materials. The hose 90 may advantageously be corrugated. In someexamples, the proximal end connector 88 of the smoke evacuation hose 90is a uniquely shaped connector 88 such as square or triangular forexample.

In some examples, the waste air management system 84 may safely processthe waste air that is the by-product of the operating room ventilationoptimization system. It has been shown that flow-boundary dead zonesnaturally form around the surgeons and in front of anesthesia screen.This is a natural phenomenon that occurs anytime a fluid (or gas) flowsnext to a non-moving object—a boundary layer of non-moving fluid (orgas) is formed as shown in FIG. 21A. These flow-boundary “dead zones”110 that form around the surgeons 108 and staff, effectively prevent thedownward ventilation airflow 112 from the ceiling of the operating roomfrom reaching the open surgical wound 114. When the ventilation airflow112 stops, contaminating particles and bacteria that had been keptairborne by the moving air, are allowed to settle into the wound 114.When the ventilation airflow 112 slows or even stops due to dead zone110 interference, gravity takes over and the airborne contaminatessettle into the wound 114 where they may cause infections.

In some examples, and as shown in FIG. 21B, we have shown that thenegative effects of these dead zones 110 can be minimized by vacuumingout the dead zone air, which allows the ventilation air 112 to flow pastthe wound 114, keeping airborne contaminating particles and bacteria,airborne in the moving air where they do no harm.

In some examples, and as shown in FIG. 21B, a ventilation optimizationsystem includes ventilation dead zone 110 evacuation; by vacuuming theair from the flow-boundary dead zones 110 that naturally form in frontof the surgeons 108 and anesthesia screen 30, the interference of theflow-boundary layers with the operating room ventilation 112 is reduced.This allows the ventilation airflow 112 from the ceiling to reach thewound 114 unimpeded by a flow-boundary dead zone 110. These interferingdead zones 110 of non-moving air can be evacuated by placing a distalend 116, 116A-C (e.g., distal end portion) of vacuum hose(s) 90 into thedead zone 110 to suck out or literally deflate the deadzone. Theevacuated air can then be processed in order to safely discharge theair, back into the operating room. In some examples, the distal end 116of the vacuum hose 90 (e.g., dead zone evacuation hose) may be securedto the sterile surgical drape, such as near or in front of the surgeon108 (e.g., surgeon position), with an adhesive element. Any othersuitable securing method, such as, but not limited, to clips and tiesmay also be provided.

In some examples, the distal end 116 of the vacuum hose 90 may include asingle large hole between the inside and the outside of the vacuum hose90. The single large hole may be substantially the same diameter as thevacuum hose 90. The large hole allows unimpeded airflow while producingminimal airflow noise. In some examples, there are multiple relativelylarge holes (>0.25 in. diameter) near the distal end 116 of the vacuumhose 90. In some examples, there are multiple smaller holes (<0.25 in.diameter) near the distal end 116 of the dead zone evacuation hose 90,essentially creating a screen-like air inlet to vacuum hose 90. Thenumber of holes and the size of the holes is determined so as to allowan air flow of between 5 and 50 CFM.

In some examples, the distal end 116 of the vacuum hose 90 may be usedto evacuate surgical smoke. Traditionally, surgical smoke is evacuatedby an air hose attached directly to the end of the electrosurgicalactive electrode or “pencil.” Surgeons find this added hose to becumbersome. The distal end 116 of the vacuum hose 90 may be locatedadjacent the surgical wound 114 and can evacuate the surgical smoke fromabove the surgical wound 114 being carried in the ventilation airflow112, as it flows past the distal end 116. In this case, a cumbersomehose attached directly to the end of the electrosurgical “pencil” may beunnecessary. By evacuating the dead zone 110 with the vacuum hose 90,the ventilation airflow 112 containing the surgical smoke is naturallydirected from over the wound 114, laterally toward the distal end 116 ofthe vacuum hose 90 adjacent the surgeon 108.

In some examples, the distal end 116 of the vacuum hose may be placed inother flow boundary layer or ventilation dead zone areas such as thosethat form next to the anesthesia screen 30, under the surgical lights orunder a Mayo stand. Similar to the ventilation flow dead zones that formin front of the surgeons, these other dead zones can be evacuated inorder to allow the ventilation airflow 112 to flow unimpeded and thuskeep the contaminating airborne particles airborne.

Features of the vacuum hose 90 and distal end 116, 116A-C can also beused to collect air from areas of the surgical field that are notconsidered dead zones, but that may benefit from air collection andfiltering. Some of these areas can include areas of turbulent ornon-laminar airflow. Air collection using vacuum hose 90 may also beperformed in areas of generally laminar airflow.

In some examples, the proximal end of the dead zone evacuation hose 90exiting from the surgical field may be attached to the inlet vent 86 ofthe waste air management system 84 (FIGS. 16, 17 ). The waste air fromthe dead zone evacuation may be safely filtered in the waste airmanagement system 84. In some examples, the hose 90 for dead zoneevacuation may be lightweight, thin walled, inexpensive hose, ½-2 inchesin diameter. The hose 90 may advantageously be made of polyethylene,polypropylene, PVC or other plastic materials. The hose 90 mayadvantageously be corrugated. In some examples, the proximal end of thedead zone evacuation hose 90 is a uniquely shaped connector 88 such assquare or triangular for example (FIGS. 20, 22 ).

In some examples, the waste air management system 84 may be used toevacuate or dilute the air under the surgical drape (e.g., 32 in FIG. 4), especially near the patient's head, neck and chest (e.g., near 24 inFIG. 4 ). Alcohol from the surgical prep solution may pool under thesurgical drapes 32 and then evaporate. Waste oxygen from an unrestrictedoxygen supplementation system such as nasal prongs or facemask may allowwaste oxygen to pool under the surgical drape, especially near thepatient's head, neck and chest. When a spark from either theelectro-cautery or a laser is added, highly dangerous operating roomfires can occur. Even the surgical drape can burn in the presence of anoxygen-enriched environment. It may be advantageous to remove the airand oxygen and alcohol vapors trapped under the surgical drape.

In some examples, and as shown in FIG. 22 , a vacuum hose 90 may beplaced near the shoulders, chest and neck of the patient. Vacuum hose 90may include any of the features described with reference to vacuum hose90 described with respect to FIGS. 20, 21A and 21B. The distal end 116′of the oxygen/alcohol vacuum hose 90 may terminate in a single hole,multiple holes or even multiple smaller hose “tentacles” 126A′, 126B′,each with one or more holes 128A′ and/or 128B′ and each located near thepatient. In some examples, longer “tentacle” oxygen/alcohol vacuum hoses126A′, 126B′ may extend over the patient's chest or along their sides toterminate with the holes 128A′, 128B′ near the abdomen. In someexamples, the distal end of the “tentacle” hoses 126A′, 126B′ may besecured to the patient with one or more adhesive patches 130A′ and/or130B′. The adhesive patches can include any suitable coupling element,and can alternately be couplable to the anesthesia screen, surgicaldrape, etc.

In some examples, the proximal end of the vacuum hose 90 for evacuatingoxygen/alcohol exiting from the surgical field may be attached to theinlet vent 86 of the waste air management system 84. The waste air fromthe oxygen/alcohol evacuation vacuum hose 90 may be safely filtered inthe waste air management system 84. In some examples, the vacuum hose 90for oxygen/alcohol evacuation may be lightweight, thin walled,inexpensive hose, ⅜-1 inch in diameter. The vacuum hose 90 mayadvantageously be made of polyethylene, polypropylene, PVC or otherplastic materials. The vacuum hose 90 may advantageously be corrugated.In some examples, the proximal end of the oxygen/alcohol evacuationvacuum hose 90 is a uniquely shaped connector 88 such as square ortriangular for example.

In some examples, the waste heated air can be vacuumed by the waste airmanagement system 84, filtered and discharged at a height that does notallow any waste heat to mobilize contaminates normally resident near thefloor, up and into the sterile field. In other words, the air dischargedfrom the waste air management system 84 may advantageously be at aheight that is greater than 4 feet off of the floor. However, in someexamples, at least a portion of the air discharged from the waste airmanagement system 84 may be diverted and used as a source of positivepressure air.

For example, the waste air management system 84 may be used to dilutethe air under the surgical drape (e.g., 30, FIG. 4 ), especially nearthe patient's head, neck and chest. Alcohol from the surgical prepsolution may pool under the drapes and then evaporate. Waste oxygen froman unrestricted oxygen supplementation system such as nasal prongs orfacemask may allow waste oxygen to pool under the surgical drape,especially near the patient's head, neck and chest. When a spark fromeither the electro-cautery or a laser is added, highly dangerousoperating room fires can occur. Therefore, in contrast to vacuumingwaste air and oxygen, it may be advantageous to dilute the air andoxygen and alcohol vapors trapped under the surgical drape by blowingfresh air into the space under the drapes. In some examples, this aircan be provided by the air discharged from the waste air managementsystem 84.

In some examples, and again with reference to FIG. 22 , the air hose116′ may be configured to be placed near the shoulders, chest and neckof the patient. The distal end of the oxygen/alcohol evacuation/dilutionair hose 116′ may terminate in a single hole, multiple holes or evenmultiple smaller hose “tentacles” 126A′, 126B′, each with one or moreholes 128A′, 128B′ and each located near the patient. In some examples,longer “tentacle” oxygen/alcohol dilution air hoses 126A′, 126B′ mayextend over the patient's chest or along their sides to terminate withthe holes near the abdomen. In some examples, the distal end of the“tentacle” air hoses 126A′ may be secured to the patient, a table or asurgical drape with an adhesive patch 130A′ and/or 130B′.

In some examples, the proximal end of the oxygen/alcohol dilution airhose exiting from the surgical table may be attached to the outletconnector 118 of the waste air management system 84. The outletconnector 118 may attach to the discharge side of the waste airmanagement system 84 in order to utilize the positive pressure air beingdischarged from the system 84. In some examples, the air hose 116′ foroxygen/alcohol dilution air may be lightweight, thin walled, inexpensivehose, ⅜¾ inch in diameter. The air hose 116 may advantageously be madeof polyethylene, polypropylene, PVC or other plastic materials. The airhose 116 may advantageously be corrugated. In some examples, theproximal end of the oxygen/alcohol dilution air hose 116 is a uniquelyshaped connector 88 such as square or triangular for example.

In some examples, the output of the waste air management system 84 maybe diverted into an air hose (e.g., 116) that may be hooked to aninflatable “hover” mattress for moving the patient off of the surgicaltable at the end of surgery. The fan 96 in the waste air managementsystem 84 conveniently provides the pressurized air for a “hover”mattress. Air may be diverted from the outlet side of the waste airmanagement system 84, into an air hose 116 that is attached to a “hover”mattress. Since the “hover” mattress requires higher air pressure andhigher airflow than the low velocity low pressure airflow normallyproduced by the waste air management system, the fan 96 of the waste airmanagement system 84 may advantageously have two or more speeds. Whenthe “hover” mattress is in use, the fan 96 of the waste air managementsystem 84 may be speeded up to a higher RPM, thus delivering higher airpressures and air volumes, accepting a brief period of more fan noise.In contrast, under normal conditions when the “hover” mattress is notinflated, the fan 96 may be operated at a slower speed to reduce theannoying fan noise.

In some examples, when the output of the waste air management system 84is diverted into an air hose (e.g., 116) that is hooked to an inflatable“hover” mattress, the diversion valve may automatically close the normalexhaust ducting 102. Therefore, the air pressure in the diversion airhose 116 may be substantially increased, as required to inflate theinflatable “hover” mattress.

As shown in the illustrative module 2810 of FIG. 28 , in some examples,one or more fluid suction canisters 154 for waste fluid and blood may beconveniently mounted on the module 2810. A vacuum hose 300 from the ORceiling to, for example, the top of the tower of the module 2810 caneliminate the need for that hose to traverse the floor from a walloutlet. Mounting the fluid suction canisters 154 on the module 2810 alsoallows the suction hose 160 from the surgical field to reach the fluidsuction canister 156 without touching the floor.

In some examples as shown in FIG. 28 , the one or more fluid suctioncanisters 154 may be accommodated in bucket-like recesses 156 formed inor coupled to the module 2810, on the side facing away from the patient48 or the rear side 50 of the module 2810. In the case of multiplecanisters, the suction hose 160 from the surgical field may be splitinto two or more “tail” hoses that can each be hooked to the top of acollection canister 154 (e.g., fluid suction canister, waste fluidstorage device). In some examples, two or more vacuum hoses 162 mayemerge from the module 2810 cowling 12 to be attached to the top of thefluid suction canisters 154. In some examples, the two or more vacuumhoses 162 can include one or more flow valves 161. In some examples,each vacuum hose 162 can have a flow valve 161, to control which fluidsuction canister 154 is receiving the vacuum at any given time. The oneor more flow valves 161 can include any suitable flow managing device.

In some examples as shown in FIG. 29 , the one or more fluid suctioncanisters 154 may include a disposable fluid suction bag 158 that servesas an inner liner for fluid suction canister 154, or can replace fluidsuction canister 154. The disposable fluid suction bag 158 prevents themore robust and expensive fluid suction canister 154 from beingcontaminated by blood and bodily fluids. In this case, the vacuum hose162 from the module 2810 and the suction hose 160 from the surgicalfield both enter the top of the disposable fluid suction bag 158. Insome examples, the top of the disposable fluid suction bag 158 caninclude a molded plastic cover 164 with a diameter that is larger thanthe upper diameter of the fluid suction bag 158. The outer rim of themolded plastic cover 164 is designed to create an airtight seal with theupper edge of the fluid suction canister 154. When the molded plasticcover 164 is sealed to the upper edge of the fluid suction canister 154,a vacuum 198 can be introduced into the space between the fluid suctionbag 158 and the fluid suction canister 154. The negative pressure vacuum198 in the space between the fluid suction bag 158 and the fluid suctioncanister 154 may be more negative than the negative pressure vacuuminside the fluid suction bag 158, in order to maintain the fluid suctionbag 158 in a fully expanded condition.

In some examples, the negative pressure vacuum 198 in the space betweenthe fluid suction bag 158 and the fluid suction canister 154 can beinduced by one or more vacuum pumps in the module 2810. Advantageously,these vacuum pumps can be capable of creating a more negative airpressure than the hospital vacuum system that is applied to the insideof the fluid suction bag 158.

In some examples, the fluid suction bag 158 can be made of plastic film.In some examples, the fluid suction bag 158 can be made of blow-moldedplastic. Other plastic bag construction techniques are anticipated. Insome examples, the fluid suction bag 158 is made of inexpensivepolyethylene or polypropylene plastic materials.

In some examples, one or more fluid level sensors 153, such as, but notlimited to, optical or infrared sensors, may be conveniently mounted inthe wall of the bucket-like recesses 156 in the module 10, adjacent thefluid suction canister(s) 154. Optical and infrared sensors rely on therelative increased absorption of transmitted light by blood and fluidcompared to air in order to determine a fluid level. In some examples,the fluid level monitors may automatically activate or deactivate thevacuum valves to a given canister, thereby automatically shifting theblood and fluid flow to a new canister as the previous one is filled. Insome examples, the surgical nurse can be wirelessly notified on theirportable monitor, that one or more canisters are full of blood and fluidand may need to be replaced before the surgical procedure is finished.

Blood and fluid sucked from the surgical sight frequently contains manyair bubbles and foam that falsely expand the blood and fluid volume andmay cause the canister to overflow, if volume were to be measured byweight for example. In some examples, optical or infrared fluid levelsensors 153 may be advantageous compared to other fluid level sensorsbecause they respond to an absolute volume of fluid (including airbubbles and foam) in the fluid suction bag 158 or the fluid suctioncanister 154. In some examples, optical or infrared fluid level sensors153 ideally serve as a shutoff sensor, preventing the overflow of bloodand fluids into the hospital vacuum system.

In some examples, optical or infrared fluid level sensors 153 may not beideal for determining an accurate blood and fluid volume in the fluidsuction bag 158 or the fluid suction canister 154. An accurate blood andfluid volume needs to subtract the volume added by air bubbles and foam.In some examples, weight is the most accurate determination of the bloodand fluid volume in the fluid suction bag 158 or the fluid suctioncanister 154, because it excludes the confounding influence of airbubbles. By subtracting the dry weight of the fluid suction bag 158and/or the fluid suction canister 154 from the measured weight of thecanister containing blood and fluid, the volume of blood and fluid caneasily and accurately be determined, irrespective of the volume of airbubbles and foam in the blood and fluid.

In some examples, an electronic scale 155 is positioned to weigh thefluid suction canister 154. Measuring the weight of the blood and fluidis far more accurate than the traditional method of visually measuringor “guesstimating” the volume of blood and fluid in a fluid suction bag158 or the fluid suction canister 154. Since blood and fluid hasvirtually the same specific gravity as water, each 1 gram of blood andfluid weight equates to 1 ml of blood and fluid volume. The volume ofthe air bubbles and foam are automatically excluded.

In some examples, the fluid suction bag 158 and/or the fluid suctioncanister 154 can be attached to an electronic scale 155 for measuringthe weight of the fluid suction bag 158 and/or the fluid suctioncanister 154 plus the blood and fluid in the bag or canister. In someexamples, the electronic output of the electronic scale 155 that can beattached to the fluid suction canister 154 is directly reported on apatient monitor display 38A, 38B. In some examples, the electronicoutput of the electronic scale 155 that is attached to the fluid suctioncanister 154 is digitized and reported (e.g., generated and a signalsent) to a processor (such as processing circuitry 157) that isprogramed to record the beginning weight (e.g., establish a zero point)of the fluid suction bag 158 and/or the fluid suction canister 154 andtogether (operably coupled) with a controller 165 a of a control module165 b, automatically subtract that beginning weight from subsequentrecorded fluid suction canister 154 weights, to determine the blood andfluid loss during surgery. In some examples, the total blood and fluidloss and in some cases blood and fluid loss per hour determined (e.g.,calculated) by the processor, are then reported (e.g., displayed) on apatient monitor display 38A, 38B. In some examples, the total blood andfluid loss and in some cases blood and fluid loss per hour determined bythe processor, may be automatically recorded in the electronicanesthetic record (e.g., a memory, machine readable medium). Other timevalues besides fluid loss per hour can be used, such as fluid loss perminute, fluid loss per second, etc.

In some examples, it may be desirable to determine the blood loss duringsurgery rather than total blood and fluid loss, since some or even mostof the “fluid” is irrigation fluid introduced by the surgeon. The bloodloss can be determined by comparing information about a concentration ofa blood characteristic in the waste fluid. Blood characteristics thatcan be used include, but are not limited to, hematocrit concentrationand hemoglobin concentration. For example, blood loss can be calculatedif the hematocrit (Hct) or hemoglobin concentration (Hgb) of thepatient, the hematocrit (Hct) or hemoglobin concentration (Hgb) of thefluid in the suction canister 154 and the volume of the blood and fluidin the suction canister 154 (excluding air bubbles and foam) are known.The formula is: Blood loss=Hct_(canister)/Hct_(patient)×fluidvol_(canister). Accurate measurement of the fluid volume of the canisterby weight has been discussed. The Hct of the patient can be directlymeasured by infrared spectroscopy or by recent lab results. The Hct ofthe canister can be measured or approximated by a variety of techniquesincluding but not limited to: infrared spectroscopy, centrifugation,visible light photo absorption and microfluidic cell counting. In someexamples, the total blood and in some cases blood loss per hourdetermined by the processor, may be automatically recorded in theelectronic anesthetic record. In some examples, the processor mayinclude an algorithm for more accurately determining the need for ablood transfusion. For example, the processor can determine if ameasured blood loss value has traversed a blood loss threshold.

In some examples, it may be desirable to agitate and mix the contents ofthe fluid suction bag 158 or the fluid suction canister 154 in order toassure a more accurate determination of the Hct of the blood and fluidin the canister. In some examples, it may be desirable include amagnetic stirrer in the fluid suction bag 158 or the fluid suctioncanister 154. A small bar magnet 159 with N and S poles is placed in thebottom of the fluid suction bag 158 or the fluid suction canister 154. Acorresponding bar magnet is mounted on a spinning shaft and positionedto spin horizontally just below the bucket-like recesses 156 in themodule 10. The opposite poles of each magnet are attracted to each othercausing the magnet 159 in the canister to spin in unison with the magnetbelow the bucket-like recesses 156, mixing the blood and fluid in thecanister. In some embodiments the bar magnet 159 in the canister may becoated in plastic. In some embodiments the plastic coating may be moldedto include a substantially sphere-shaped bump located near the midpointof the magnet 159. The bump may provide an axis of rotation for themagnet 159 to more easily spin in the blood and fluid.

In some examples, it may be desirable to agitate and mix the contents ofthe fluid suction bag 158 or the fluid suction canister 154 in order toassure a more accurate determination of the Hct of the blood and fluidin the canister. In some examples, it may be desirable include a bubblerin the fluid suction bag 158 or the fluid suction canister 154. In someembodiments, the proximal end of a small tube 163 may be hooked to anair source within the module 10 and terminate with its open distal endnear the bottom of the fluid suction bag 158 or the fluid suctioncanister 154. Small air bubbles pumped into the blood and fluid in thecanister agitate and mix the contents as they rise to the surface. Thebubbles also assure that the blood in the canister is fully oxygenated,making the quantification with infrared spectroscopy or visible lightphoto absorption easier and more accurate, in some cases only requiringa single wavelength of light. In some embodiments the small tube 163 mayalso serve as a sampling tube for withdrawing a small amount of thecontents of the fluid suction canister 154 or fluid suction bag 158, foranalysis of the hematocrit.

In some examples, a suction hose from the anesthesia suction device maybe attached to fluid suction bag 158 or the fluid suction canister 154,in order to eliminate the need for additional suction canisters. Thiscombination is possible because the fluid suction bags 158 or the fluidsuction canisters 154 are mounted on the module 2810, adjacent thepatient.

In some examples, module 3010 can include a disinfecting (e.g.,sanitizing) system. For example, Ultraviolet light (UV), especially UVlight in the “C” portion of the spectrum can kill nearly all types ofmicroorganisms. In some examples, UV-C includes lights emittingwavelengths in the 200 nm to 280 nm range. Some germicidal lights may goas high as wavelengths of 300 nm. In recent years UV-C has steadilygained acceptance as an effective technique for disinfection in the OR.The challenges with UV-C disinfection include: adequate UV power orintensity (“field strength”), adequate duration of exposure, expense,adequate “sight lines” to assure that the upper surfaces of theequipment in the OR (especially the surfaces contacting the patient, thestaff and the supplies) are radiated and adequate protection of therelatively delicate UV-C bulbs when not in use.

In some examples, and as shown in FIGS. 30 and 31 , the module 3010 maybe used as a storage and mounting platform for a disinfecting system165, such as a sanitizing system including UV-C lights 166. Othersuitable disinfecting systems may also be mounted to module 3010,including but not limited to, a spray disinfecting system or an ozonedisinfecting system. In some examples, a cartridge 168 for mountingmultiple UV-C lights 166 (which may look like fluorescent light tubes)may be safely housed in the tower-like upper section 20 of module 10.

In some examples as shown in FIGS. 30 and 31 , the UV-C cartridge 168may be elevated from its storage location within the upper section 20 ofmodule 3010, emerging from the top of module 3010. (However, in someexamples the cartridge 168 may remain on top of the module 3010 and notemerge or be retracted into the module 3010).

In some examples, the UV-C cartridge 168 may advantageously be located5-9 feet in the air when it is located on the top of module 10. Fromthis relatively high location in the OR, the UV-C lights 166 canadvantageously shine outward and/or downward onto the upper surfaces ofthe equipment in the room; the surfaces contacting the patient, thestaff and the supplies.

In some examples, the UV-C cartridge 168 may be elevated above themodule 3010 by an air cylinder actuator 202 or other electro-mechanicalmechanism for UV-C exposure and then safely stored within the uppersection 20 between exposures. In other words, when in use, thesanitizing system 165 at least a portion of the system 165 can beextended out of the module 3010, and when not in use, at least a portionof the sanitizing system 165 can be retracted into the module 3010 andstored in the module 10.

In some examples as shown in FIG. 31 , the UV-C cartridge 168 mayinclude UV-C lights that extend outward 170 creating “sight lines” 204that can radiate and disinfect module 3010. The UV-C lights that extendoutward 170 may be housed in module 3010 as part of the UV-C cartridge168 and then automatically deploy outward when the UV-C cartridge 168 iselevated. The UV-C lights shining on the module 3010 advantageouslydisinfect the module 3010 automatically.

In some examples, as shown in FIGS. 30 and 31 , the UV-C lights 172 maybe mounted on module 3010 near the floor. UV-C lights near the floor172, advantageously have “sight lines” 206 to the undersurfaces ofequipment and the floor of the OR. The combination of the UV-C lights166 shining downward and the UV-C lights 172 near the floor shiningupward, outward and/or downward, creates the maximum probability ofhaving a clear “sight line” 204, 206 to an organism in any location.

In some examples, the UV-C disinfection system may be controlled by atimer. At a designated time when the OR is not in use, 3 AM for example,the UV-C cartridge 168 may be automatically elevated above the module3010 by the air cylinder actuator or other electro-mechanical mechanism202, for UV-C exposure. Then after a prescribed exposure time, theactuator 202 may automatically retract the UV-C cartridge 168 back intothe upper section 20 for safe storage. Since each OR would presumablyhave its own module 3010, each room can be automatically andeconomically disinfected with UV-C light, one or more times each day.The disinfection system can include one or more motion sensors 208 todetect motion. For example, if a person is in the room or in a locationwhere they could be exposed to the UV light, based on the detection ofmotion, the disinfection system can be altered, or the output reduced.In some examples, detection of motion can include the processor (e.g.,157) determining that the disinfection system should be interrupted andsending an instruction to the actuator 202 to retract the disinfectionsystem or to the controller to turn off the disinfection system.

In some examples, UV-C lights 166 may be mounted on rear side 50 of theupper section 20 of module 3010. In this location, warming blankets thatare hung from the top rear side 50 of the module 3010 between surgicalcases may be exposed to UV-C light and disinfected on the side of theblanket contacting the patient. The UV-C lights 166 would be blockedfrom shining around the room by the blankets hanging in front of thelights, therefore even though personnel may be in the room during caseturnover, they will not be exposed to UV-C light. The side of theblankets facing the patient can be disinfected between cases without theneed for wiping them off.

In some examples, the various features and inventions described hereinfor safely and efficiently relocating and housing unrelated equipment inthe OR, may be advantageously adapted to house equipment elsewhere inthe operating room or elsewhere in the hospital or surgery center. Forexample, equipment or digital displays used by the surgeon may be housedin a module very similar to module 10 but be preferentially located nearthe side of the surgical table on the surgical side of the anesthesiascreen 30, rather than near the head of the table. It is anticipatedthat the various features and inventions described herein for safely andefficiently relocating and housing equipment in the OR, may be used tocreate modules with different form factors, or modules for differentpurposes, or modules for use in different locations, or modules for useby different surgical staff, without deviating from the intended scopeof this invention.

In some examples, the module 10 of the instant invention may alsoinclude the components of an anesthetic gas machine (e.g., 40). Thecomponents of an anesthetic gas machine can include but are not limitedto: O₂, N₂O and air supply lines and tanks; piping, valves and flowmeters for O₂, N₂O and air; anesthetic gas vaporizers; a circle systembreathing circuit with a CO₂ absorption canister and ventilation bag; amechanical ventilator; pressure and gas concentration monitors.Including the anesthetic gas machine 40 components and functions in themodule 10, advantageously eliminates another piece of equipment fromcluttering the operating room and requiring cleaning.

FIG. 33 illustrates an electronic and/or electromechanical system 3300of a surgical module (e.g. 10) in accordance with some examples. Thesystem 3300 can include any of the features described in FIGS. 1-32B toperform techniques 3400-4000 described in relation to FIGS. 34-40 , forexample, by using the processor 157. The system 3300 can includecircuitry 3302. In some examples, the circuitry 3302 can include but isnot limited to, electronic circuits, a control module processingcircuitry and/or a processor, 3304 (e.g., 157, FIG. 1 ). Thecircuitry/processor 3302/3304 may be in communication with a memory 3306and/or a storage device 3308. A single processor can coordinate andcontrol multiple, or even all the aspects of the system 3300 (module10), or multiple processors can control all the aspects of the system3300 (module 10). In some examples the storage device 3308 can includeat least a portion of the patient's anesthetic record saved thereon. Thesystem 3300 can also include a fan 3310 and a display 3312 (e.g., 38A,38B, 38C). The system 3300 can also include any of the circuitry andelectronic and/or electromechanical components described herein,including but not limited to, blood measuring sensor(s) 3314 (e.g.,weight sensor or scale, light sensor, optical sensor, ultrasonic sensoretc.); a urine sensor(s) 3316, a vacuum pump 3318, a vacuum pump flowmanaging device 3320, an airflow managing device (e.g., a diversionvalve for diverting airflow) 3322. The system 3300 may also include orinterface with accessories or other features 3340 such as any of: awireless tablet 3350, a surgical mattress 3352, a surgical compressiondevice 3354, a dead zone evacuation system 3356, a sponge counting anddetection system 3358 a positive pressure air dilution system 3360, aswell as any of the other systems described herein.

The circuitry 3302, which in some examples can include processor 3304 ofthe surgical module 10 can receive information from the various sensorsdescribed herein, make various determinations based on the informationfrom the sensors, output the information or determinations from theinformation for output on the display or wireless tablet, outputinstructions to provide an alert or an alarm, apply vacuums, powervarious components such as a fan, actuate actuators, flow managingdevices, diversion valves, etc. as described herein. For the sake ofbrevity, select systems and combinations are described in further detailabove and in the example sets provided in the Notes and Various Examplessection below. Other embodiments are possible and within the scope ofthis disclosure.

FIG. 34 illustrates a flow chart showing a technique 3400 for vacuumingair in an operating room using system 3300 (e.g., including any module,such as module 10, described herein) in accordance with some examples.The technique 3400 can include operation 3402 to receive instructions topower a fan disposed in a surgical module. Operation 3404 can includeproviding power to the fan to cause air to flow through a specifiedchannel of the module. The specified channel can include a plenum and avent tube as described herein. Operation 3406 can include receivingadditional instructions, operation 3408 determining actions andoperation 3410 sending instructions based on the determined actions.Technique 3400 can include additional steps as well as the more detailedsteps outlined in Example Set 1 under the Various Notes and Embodimentssection.

FIG. 35 illustrates a flow chart showing a technique 3500 for reducinggerms in an operating room using system 3300 (e.g., including anymodule, such as module 10) in accordance with some examples. Thetechnique 3500 can include operation 3502 including determining whetherto activate a disinfection system. Operation 3504 can include activatingthe disinfection system. Operation 3506 can include deactivating thedisinfections system (such as by receiving an instruction to deactivatethe system or after a period of time passes). Technique 3500 can includeadditional steps as well as the more detailed steps outlined in ExampleSet 2 under the Various Notes and Embodiments section.

FIG. 36 illustrates a flow chart showing a technique 3600 for monitoringwaste fluid during a surgery using system 3300 (e.g., including anymodule, such as module 10) in accordance with some examples. Thetechnique 3600 can include operation 3602 including receivinginformation from a sensor about an amount of waste fluid collected overtime. Operation 3604 can include determining a delta. Operation 3606 caninclude outputting the delta, such as for display by an electronicdevice mounted on the system 3300 or on a wireless tablet device.Operation 3608 can include saving the delta to a storage device. In someexamples, the storage device can include at least a portion of thepatient's anesthetic record thereon. Technique 3600 can includeadditional steps as well as the more detailed steps outlined in ExampleSet 3 under the Various Notes and Embodiments section.

FIG. 37 illustrates a flow chart showing a technique 3700 for applyingvacuums using system 3300 (e.g., including any module, such as module10), in accordance with some examples. The technique 3700 can includeoperation 3702 receiving an instruction to secure a module to a floor.Operation 3704 can include applying a vacuum to a suction cup. Operation3706 can include receiving an instruction to de-couple the suction cup,and based on the instruction, in operation 3708 releasing the vacuum(e.g., by venting to atmosphere) and actuating a lifting element tode-couple the suction cup. Technique 3700 can also include methods ofapplying the vacuum to waste fluid systems described herein. Technique3700 can include additional steps as well as the more detailed stepsoutlined in Example Set 4 under the Various Notes and Embodimentssection.

FIG. 38 illustrates a flow chart showing a technique 3800 for measuringurine output from a catheterized patient using system 3300 (e.g.,including any module, such as module 10), in accordance with someexamples. The technique 3800 can include operation 3802 receivinginformation related to urine weight output. Operation 3804 can includedetermining a volume of urine from the urine weight. Operation 3806 caninclude saving the urine volume to a storage device. In some examplesthe storage device can include at least a portion of a patient'sanesthetic record stored thereon. Technique 3800 can include additionalsteps as well as the more detailed steps outlined in Example Set 5 underthe Various Notes and Embodiments section.

FIG. 39 illustrates a flow chart showing a technique 3900 for operatinga module (e.g., any module herein, such as module 10) using system 3300,in accordance with some examples. The technique 3900 can includeoperation 3902 receiving an instruction to provide air. Operation 3904sending an instruction to an air pump causing air to be provided to asurgical air mattress or a surgical compression device. Operation 3906can include receiving an instruction to activate a fan. Operation 3908can include activating the fan. Operation 3910 can include receivinginformation about the surgical air mattress or the surgical compressiondevice. Operation 3912 can include determining if the informationtraverses a threshold. Operation 3914 can include diverting airflow fromthe fan to the surgical air mattress of the surgical compression device.Technique 3900 can include additional steps as well as the more detailedsteps outlined in Example Set 6 under the Various Notes and Embodimentssection.

FIG. 40 illustrates a flow chart showing a technique 4000 for filteringair in a surgical field using system 3300 (e.g., including any module,such as module 10), in accordance with some examples. The technique 400can include operation 4002 of providing or receiving a first electronicor electromechanical surgical equipment module. Operation 4004 ofproviding or receiving a second electronic or electromechanical surgicalequipment module. Operation 4006 can include containing the waste heatgenerated by the modules inside of the housing. Operation 4008 caninclude receiving an instruction. Operation 4010 can include actuating afan based on the received instruction. Upon operation of the fan,operation 4012 can include receiving airflow into the housing. Operation4014 can include passing the airflow through a filter. Operation 4016can include blowing airflow through a vent tube, and operation 4018 caninclude exhausting at least a portion of the airflow and the waste heatout of the housing. Technique 4000 can include additional steps as wellas the more detailed steps outlined in Example Set 7 under the VariousNotes and Embodiments section.

FIG. 41 illustrates generally an example of a block diagram of a machine(e.g., of module 10) upon which any one or more of the techniques (e.g.,methodologies) discussed herein may perform in accordance with someembodiments. In alternative embodiments, the machine 4100 may operate asa standalone device or may be connected (e.g., networked) to othermachines. In a networked deployment, the machine 4100 may operate in thecapacity of a server machine, a client machine, or both in server-clientnetwork environments. The machine 4100 may be a personal computer (PC),a tablet PC, a personal digital assistant (PDA), a mobile telephone, aweb appliance, a network router, switch or bridge, or any machinecapable of executing instructions (sequential or otherwise) that specifyactions to be taken by that machine. Further, while only a singlemachine is illustrated, the term “machine” shall also be taken toinclude any collection of machines that individually or jointly executea set (or multiple sets) of instructions to perform any one or more ofthe methodologies discussed herein, such as cloud computing, software asa service (SaaS), other computer cluster configurations.

Examples, as described herein, may include, or may operate on, logic ora number of components, modules, or like mechanisms. Such mechanisms aretangible entities (e.g., hardware) capable of performing specifiedoperations when operating. In an example, the hardware may bespecifically configured to carry out a specific operation (e.g.,hardwired). In an example, the hardware may include configurableexecution units (e.g., transistors, circuits, etc.) and a computerreadable medium containing instructions, where the instructionsconfigure the execution units to carry out a specific operation when inoperation. The configuring may occur under the direction of theexecution units or a loading mechanism. Accordingly, the execution unitsare communicatively coupled to the computer readable medium when thedevice is operating. For example, under operation, the execution unitsmay be configured by a first set of instructions to implement a firstset of features at one point in time and reconfigured by a second set ofinstructions to implement a second set of features.

Machine (e.g., computer system) 4100 may include a hardware processor4102 (e.g., a central processing unit (CPU), a graphics processing unit(GPU), a hardware processor core, or any combination thereof), a mainmemory 4104 and a static memory 4106, some or all of which maycommunicate with each other via an interlink (e.g., bus) 4108. Themachine 4100 may further include a display unit 4110, an alphanumericinput device 4112 (e.g., a keyboard), and a user interface (UI)navigation device 4114 (e.g., a mouse). In an example, the display unit4110, alphanumeric input device 4112 and UI navigation device 4114 maybe a touch screen display. The display unit 4110 may include goggles,glasses, or other AR or VR display components. For example, the displayunit may be worn on a head of a user and may provide a heads-up-displayto the user. The alphanumeric input device 4112 may include a virtualkeyboard (e.g., a keyboard displayed virtually in a VR or AR setting.

The machine 4100 may additionally include a storage device (e.g., driveunit) 4116, a signal generation device 4118 (e.g., a speaker), a networkinterface device 4120, and one or more sensors 4121, such as a globalpositioning system (GPS) sensor, compass, accelerometer, or othersensor. The machine 4100 may include an output controller 4128, such asa serial (e.g., universal serial bus (USB), parallel, or other wired orwireless (e.g., infrared (IR), near field communication (NFC), etc.)connection to communicate or control one or more peripheral devices.

The storage device 4116 may include a machine readable medium 4122 thatis non-transitory on which is stored one or more sets of data structuresor instructions 4124 (e.g., software) embodying or utilized by any oneor more of the techniques or functions described herein. Theinstructions 4124 may also reside, completely or at least partially,within the main memory 4104, within static memory 4106, or within thehardware processor 4102 during execution thereof by the machine 4100. Inan example, one or any combination of the hardware processor 4102, themain memory 4104, the static memory 4106, or the storage device 4116 mayconstitute machine readable media.

While the machine readable medium 4122 is illustrated as a singlemedium, the term “machine readable medium” may include a single mediumor multiple media (e.g., a centralized or distributed database, orassociated caches and servers) configured to store the one or moreinstructions 4124.

The term “machine readable medium” may include any medium that iscapable of storing, encoding, or carrying instructions for execution bythe machine 4100 and that cause the machine 4100 to perform any one ormore of the techniques of the present disclosure, or that is capable ofstoring, encoding or carrying data structures used by or associated withsuch instructions. Non-limiting machine readable medium examples mayinclude solid-state memories, and optical and magnetic media. Specificexamples of machine readable media may include: non-volatile memory,such as semiconductor memory devices (e.g., Electrically ProgrammableRead-Only Memory (EPROM), Electrically Erasable Programmable Read-OnlyMemory (EEPROM)) and flash memory devices; magnetic disks, such asinternal hard disks and removable disks; magneto-optical disks; andCD-ROM and DVD-ROM disks.

The instructions 4124 may further be transmitted or received over acommunications network 4126 using a transmission medium via the networkinterface device 4120 utilizing any one of a number of transferprotocols (e.g., frame relay, internet protocol (IP), transmissioncontrol protocol (TCP), user datagram protocol (UDP), hypertext transferprotocol (HTTP), etc.). Example communication networks may include alocal area network (LAN), a wide area network (WAN), a packet datanetwork (e.g., the Internet), mobile telephone networks (e.g., cellularnetworks), Plain Old Telephone (POTS) networks, and wireless datanetworks (e.g., Institute of Electrical and Electronics Engineers (IEEE)4102.11 family of standards known as Wi-Fi®, as the personal areanetwork family of standards known as Bluetooth® that are promulgated bythe Bluetooth Special Interest Group, peer-to-peer (P2P) networks, amongothers. In an example, the network interface device 4120 may include oneor more physical jacks (e.g., Ethernet, coaxial, or phone jacks) or oneor more antennas to connect to the communications network 4126. In anexample, the network interface device 4120 may include a plurality ofantennas to wirelessly communicate using at least one of single-inputmultiple-output (SIMO), multiple-input multiple-output (MIMO), ormultiple-input single-output (MISO) techniques. The term “transmissionmedium” shall be taken to include any intangible medium that is capableof storing, encoding or carrying instructions for execution by themachine 4100, and includes digital or analog communications signals orother intangible medium to facilitate communication of such software.

Method examples described herein may be machine or computer-implementedat least in part. Some examples may include a computer-readable mediumor machine-readable medium encoded with instructions operable toconfigure an electronic device to perform methods as described in theabove examples. An implementation of such methods may include code, suchas microcode, assembly language code, a higher-level language code, orthe like. Such code may include computer readable instructions forperforming various methods. The code may form portions of computerprogram products. Further, in an example, the code may be tangiblystored on one or more volatile, non-transitory, or non-volatile tangiblecomputer-readable media, such as during execution or at other times.Examples of these tangible computer-readable media may include, but arenot limited to, hard disks, removable magnetic disks, removable opticaldisks (e.g., compact disks and digital video disks), magnetic cassettes,memory cards or sticks, random access memories (RAMs), read onlymemories (ROMs), and the like.

The modules described herein with respect to FIGS. 1-42 , and includingthe machine 4100, can include features to help with medical aspectsincluding monitoring medication and anesthesia delivery, and otherfunctions, as well as documenting medication and anesthesia delivery,and other functions. In general, doctors and nurses are not interestedin replacing themselves and their jobs with automated drug delivery orautomated anesthesia systems. However, there is great interest inautomated record keeping. Virtually all anesthesia providers wouldprefer the “old” paper record and a pen to the “new” computer records.Filling out the electronic anesthetic record (EAR) using a computerkeyboard, mouse and various menus is widely viewed as a slow, cumbersomeand distracting process. The challenge with automated record keeping isautomating the data input that documents the numerous activities,anesthesia related events, fluid, gas and medication administration,ventilator settings, pressure off-loading effectiveness, as well asoutputs such as blood loss and urine output, that constitute ananesthetic experience.

The second challenge in implementing an automated electronic anestheticrecord (EAR) 201 or electronic medical record (EMR) 201 is to force aslittle change in the caregiver's routine as possible onto the cliniciansusing this system. Medical personnel tend to be creatures of habit andtradition and they generally do not like change. For example, IVmedications are traditionally administered from a syringe and the doseis determined by the caregiver observing the plunger moving relative toa scale printed on the syringe. Maintaining this general technique ofdrug administration may have the highest probability of acceptance byhealthcare users who are typically slow to embrace changes in theirroutine.

FIG. 42 illustrates an isometric view of a relocation module 4210.Relocation module 4210 can include any of the features shown anddescribed in FIGS. 1-41 , including module 10 of FIG. 1 . Relocationmodule 4210 can include an example system for generating an automatedelectronic anesthetic record (EAR) (e.g., system 228), wherein thesystem 228 can be located proximate to a patient. The module 4210 can bea module for housing unrelated electronic and electromechanical surgicalequipment (as described, for example, with respect to module 10 of FIG.1 ). However, the module 4210 does not need to include all of thefeatures described herein, and does not need to include all the featuresof module 10, although it may. For example, the module 4210, and anyother example modules described herein, need not necessarily beconfigured to house unrelated electronic and electromechanical surgicalequipment in all examples, and other modules can include the system forgenerating an automated EAR 201. Like numerals can represent likecomponents, therefore not all of the components are described in furtherdetail.

The module 4210 can include automated EAR system 201 that can includeone or more systems (e.g., 228, 230) configured to measure (e.g.,monitor) and record one or more of functions involved in a surgicalanesthetic environment, and can include life support functions. The oneor more systems 228, 230 can measure and record data automatically.However, in some examples, a user may initiate the system to measureand/or record data. These various measurements may be electronicallyrecorded and displayed on the electronic anesthetic record display 226.Inputs to the automated EAR system 201 may be managed by the anestheticrecord input component 224. The anesthetic record input component 224can include a touch-screen display that organizes all of the inputs tothe EAR 203 into easily accessed and utilized information. In someexamples, and as shown in FIG. 42 , the medication identification andmeasurement system 228 of this disclosure may be located proximate thepatient 24. The control displays for the medication identification andmeasurement system 228 may include a dedicated display proximate themedication identification and measurement system 228 or may be sharedspace on the anesthetic record input component 224. In these locations,the information and controls of the medication identification andmeasurement system 228 can be viewed by the anesthesiologist or otheruser, in a single field of vision with the patient and surgical field.

As shown in FIG. 42 , the automated EAR 203 of this disclosure may beattached to and stored within the relocation module 4210. The relocationmodule 4210 can conveniently provide direct access to the patient's 24head and therefore provides convenient mounting support location for thesystem. In some examples, the components and systems of the automatedEAR system 201 of this disclosure can be supported by other mountingsupports, including but not limited to an IV pole, a boom-mounted racksystem, a wheeled rack system and a surgical table mounting bracket. Oneor more computers including processing circuitry 157, of the automatedEAR system 201 of this disclosure may be conveniently and safely housedinside the relocation module 4210. In some examples, it is alsoanticipated that some or all of the components of automated EAR system201 of this disclosure could be used in other healthcare settings suchas the intensive care unit, the emergency room or on the ward.

In some examples, the touch-screen anesthetic record input component 224can convert to a qwerty-type keyboard to allow uncommon anesthetic andsurgical events or deviations from pre-recorded scripts, to be manuallydocumented. This allows the standard computer keyboard that is used fordata entry in most electronic anesthetic records, to be eliminated.Standard keyboards are known to be contaminated with pathogenicorganisms and are nearly impossible to clean and decontaminate due totheir irregular surfaces. In contrast, the smooth glass or plastic faceof a touch-screen monitor is easy to clean with no crevasses to hideorganisms.

In some examples, the automated EAR system 201 of this disclosure caninclude a system for automatically measuring and recording theadministration of IV medications. In some examples, the system forautomatically measuring and recording the administration of IVmedications includes a medication identification and measurement system228. As shown in FIG. 42 , the medication identification and measurementsystem 228 may be advantageously positioned proximate the patient 24,such as near the patient's head so that medications can be convenientlyadministered while tending to and observing the patient.

In some examples, the medication identification and measurement system228 may include one or more sensors, such as one or more of: a barcodereader (e.g., 236A, FIG. 44 ), a radio-frequency identification (RFID)interrogator (e.g., 238A, FIG. 44 ), or any other suitable sensor foraccurately and reliably identifying a medication for IV administration.As defined herein, a barcode reader can include any other type ofidentifying reader, such as, but not limited to, a QR code reader.Likewise, the RFID interrogator can be any type of interrogator and isnot limited to those interrogators based on radio frequency.

In some examples, instead of, or in addition to one or more of an RFIDinterrogator and a barcode reader, the system can receive an input todetermine the identity. For example, the system can include one or moreof: a sensor configured to identify the one or more IV medications orfluids, or an input configured to receive the identity of the one ormore IV medications or fluids, such as via the anesthetic record inputcomponent 224.

In some examples, the barcode reader may be a “computer vision” or“machine vision” camera 236 with the capability of reading barcodes. Theterm “machine vision” is often associated with industrial applicationsof a computer's ability to see, while the term “computer vision” isoften used to describe any type of technology in which a computer istasked with digitizing an image, processing the data it contains andtaking some kind of action. In this disclosure we will use the terms“machine vision” and “computer vision” interchangeably. Traditionally,machine vision includes technology and methods used to provideimaging-based automatic inspection and analysis, process control, androbot guidance. Machine vision is sometimes used in manufacturingenvironments. Machine vision refers to many technologies, software andhardware products including processing circuitry, integrated systems andmethods.

The inventors have discovered that machine vision can be useful beyondits traditional uses. The inventors discovered that machine vision canbe advantageous in implementing an automated EAR 203 because it offersreliable measurements, gauging, object recognition, pattern recognitionand liquid fill level measurements. Machine vision does not get tired ordistracted. Machine vision excels at quantitative measurement of astructured scene because of its speed, accuracy and repeatability.However, it does require the scene to be structured to perform thedesired function.

Machine vision can be very accurate for measuring size of an object at aknown distance or the distance of an object of known size. However, itcannot do both. Therefore, in some examples it is important to know theexact location of a syringe (e.g., 200C, FIG. 45 ) for example and thusknow the distance from the camera (e.g., 236A, FIG. 45 ) to the syringe(e.g., 200C, FIG. 45 ) in order for the machine vision to calculate thedistance of the movement of the plunger within the syringe. This is whatwe mean by the “scene being structured.”

Machine vision may be advantageous for the automated EAR system 201(EAR) of this disclosure because it “sees” and measures, but does nottouch or interfere with the anesthesia provider doing their normal jobof injecting medications or administering IV fluids. Further, the samevisual image that is used by the machine vision software can bedisplayed on a screen 226 to give the operator (whose fingers arepushing the plunger of the syringe) a close-up view of the syringe. Themachine vision is looking at the same view of the syringe as theoperator.

The machine vision camera, or digital camera, can include machine visionsoftware, or the machine vision camera can be in electricalcommunication with (e.g., operably coupled to) one or more hardwareprocessors, such as processing circuitry 152 and one or moremachine-readable mediums, that when implemented on the processingcircuitry 157, can perform the functions described herein. Theprocessing circuitry 157 can be stored in the module 4210, remote fromthe module 4210 (e.g. in a wired or wireless manner). As shown in FIG.33 , the processing circuitry 157 can be or include a processor 3304that interacts with accessories 3340 of the illustrative module 4210.For example, systems 228 and 230 can be included as accessories 3340 incommunication with other components of the surgical module 3301 as shownand described in FIG. 33 .

In some examples, the RFID interrogator 238 may be either High Frequency(HF) or Near Field (NF) RFID in order to advantageously limit theread-range to a distance of less than 12 inches. In some examples, theRFID read-range may advantageously be limited, such as to less than 8inches so that only a specific medication injection is identified at anytime. In a possibly more preferred example, the RFID read-range may belimited to less than 4 inches to further prevent mis-readings. NF-RFIDhas a short read-range by definition and the read-range of HF-RFID canbe easily limited by restricting the size of the antenna on the tag. Incontrast, longer read-range RFID such as Ultra-high Frequency (UHF-RFID)may confusingly interrogate every RFID tag in the operating room andthus be unable to identify which medication is being delivered to themedication identification and measurement system 228.

FIG. 43 illustrates a plan view of an example of preloaded syringes 200Aand 200B that can be used with the system of FIG. 42

The one or more preloaded syringes 200A and 200B may be labeled with aunique barcode label 205 or an RFID tag 207 that may identify one ormore of the drug, the concentration, the lot number, the expirationdate, the manufacturer and other important information. In someexamples, a unique barcode label 205 may be a “2-D” barcode label inorder to include more information on a smaller area than traditionalbarcode labels. In some examples, the barcode label 205 or RFID tag 207includes the drug identifying label 209A and 209B for convenient use bythe caregiver.

In some examples, the syringes 200A and 200B can be filled at the pointof use and may be labeled with drug labels 209A and 209B and eitherbarcode labels 205 or RFID tags 207 that are removably attached to thedrug bottle or vial at the factory or pharmacy. The drug labels 209A and209B and either barcode labels 205 or RFID tags 207 may be easilyremoved from the drug bottle or vial and adhesively attached to thesyringe 200A or 200B at the time that the syringe 200A or 200B is loadedwith the drug by the caregiver. Instead of, or in addition to thebarcode labels 205 or RFID tags 207, any other suitable “tag/reader”system known in the arts, may be used.

FIG. 44 illustrates a side view of an example medication identificationand measurement system and a syringe that can be used with the system ofFIG. 42 , to monitor drug delivery. FIG. 45 illustrates across-sectional view of the medication identification and measurementsystem and a syringe (not shown in cross-section) of FIG. 44 , takenalong line 45-45.

As shown in FIGS. 44 and 45 , the medication identification andmeasurement system 228A of this disclosure may include one or moreinjection portals 211A. The injection portal 211A may be a receptaclefor accommodating a syringe 200C in a fixed and known location and canbe configured to orient the Luer taper connector 213A to mate with aninjection port 215. The injection port 215 can be secured within theinjection portal 211A and can be in fluid communication with IV tubing220. In some examples, the injection portal 211A may be a clear tube216A that is sized to accommodate the syringe barrel 218A of a specificsize syringe 200C. In this example, multiple injection portals 211Awould be required to accommodate syringes 200C of different sizes.

FIG. 46 illustrates a side view of a second example medicationidentification and measurement system and a syringe that can be usedwith the system of FIG. 42 . FIG. 47 illustrates a cross-sectional viewof the second example of a medication identification and measurementsystem and the syringe (not shown in cross-section) of FIG. 46 .

As shown in FIGS. 46 and 47 , the injection portal 211B of themedication identification and measurement system 228B may be largeenough to accommodate syringes 200D of multiple sizes within the spacedefined by a real or imaginary injection portal tube 216B. In thisembodiment, accurately orienting the Luer taper connector 213B to matewith an injection port 215 may be accomplished by one or more orientingmembers such as one or more spring positioning members 222A-F thatengage with the syringe barrel 218B to center it in the injection portal211B. In some examples, there may be two or more rows of springpositioning members 222A-F. For example, spring positioning members222A, B, E, F may be located near the entrance to the injection portal211B and spring positioning members 222C, D may be located near theinjection port 215 to assure accurate positioning for mating with theLuer taper connector 213B. Spring positioning members 222 may includenot only spring wires or metal or plastic spring pieces but any flexiblematerial or combination of materials or shapes that can be deformed bythe syringe barrel 218B entering the injection portal 211B and retain amemory (e.g., elastically deformable, substantially elasticallydeformable, resiliently deformable, resilient member) so as to urge thesyringe barrel 218B into a centered position within the space defined bya real or imaginary injection portal tube 216B.

One possible objective of the spring positioning members 222A-F is to“automatically” center and align the Luer taper connector 213B of thesyringe 200B with the injection port 215, so that the operator cansimply and conveniently push the syringe 200D into the injection portal211B and no further manual alignment may be needed. The springpositioning members 222A-F can also obviate the need for the operator totouch either the Luer taper connector 213B of the syringe 200B or theinjection port 215, thus beneficially preventing accidental infectiouscontamination by the operators' fingers and gloves.

FIG. 48 illustrates a side view of a third example of a medicationidentification and measurement system and a syringe that can be usedwith the system of FIG. 42 . FIG. 49 illustrates a cross-sectional viewof the third example of a medication identification and measurementsystem and the syringe 200E (not shown in cross-section) of FIG. 48 ,taken along line 49-49.

As shown in FIGS. 48 and 49 , syringe barrel 218C may be centered andheld in place by one or more orienting members, such as compressionpositioning members 242A, B. The compression positioning members 242A, Bmay be urged apart by inserting the syringe barrel 218C there between.Springs 244A-D can compress and create a pressure pushing thecompression positioning members 242A,B against syringe barrel 218C. Thecompression positioning members 242A, B shown in the FIGS. 48 and 49 aremerely illustrative and many other sizes, shapes, numbers and locationsof compression positioning members 242 are anticipated.

Compression positioning members 242A, B may be simple spring 244A-Dactivated devices (e.g., resilient members) as shown in FIGS. 48 and 49or may be any mechanism that can expand (e.g., resiliently expand) toaccommodate syringe barrels of various sizes and urge the syringe barrel218C into a centered position within the space defined by a real orimaginary injection portal tube 216C. This example shows spring 244A, Dactivated compression positioning members 242A, B but many othermechanical activation mechanisms are anticipated. The compressionpositioning members 242A, B can be elastically deformable, substantiallyelastically deformable, resiliently deformable, include one or moreresilient members.

Other examples of positioning members designed to hold an insertedsyringe 200 in the center of the injection portal 211 and thus orientingthe Luer taper 213 for mating with the injection port 215 areanticipated. Positioning the inserted syringe 200 in the center of theinjection portal 211 allows the machine vision to work from a knowndistance and thus calculations of syringe plunger movement can be veryaccurate.

In some examples, instead of the positioning members holding a syringecentrally, the positioning members can be designed to hold an insertedsyringe 200 at a known, but off center position in the injection portal211, such as if the injection port 215 is positioned off center in theinjection portal 211. Any arrangement of the positioning members thataligns the inserted syringe 200 at a known position may be provided.

In some examples, and as shown in FIGS. 45, 47 and 49 the medicationidentification and measurement system 228A-C of this disclosure mayinclude one or more “machine vision” cameras 236A-C that input digitalimages into a processor having processing circuitry 157, as shown anddescribed in FIG. 1 157 (FIG. 1 ), or 3304 (FIG. 33 ), that is programedto analyze machine vision images. In some examples, one of the imagesthat the machine vision cameras 236A-C may “see” is a barcode label 205on the syringe 200C-E, that has been inserted into the injection portal211A-C, for identifying the medication in the syringe. As previouslynoted, the barcode label 205 can identify the brand name and/or genericname of the medication in the syringe. In some examples, the barcodelabel 205 also may identify one or more of the concentration of themedication, the lot number, the expiration date and other informationthat may be useful for inventory management.

As shown in FIGS. 44, 46 and 48 , the medication identification andmeasurement system 228A-C of this disclosure can include one or moreradio frequency identification (RFID) interrogation antennas 238A-C thatinput RFID information into a processor, such as processing circuitry157 (FIG. 1 ) or 3304 (FIG. 33 ) that is programed to analyze RFID data.In some examples, the RFID interrogation antennas 238A-C can interrogatea RFID tag 207 attached to the syringe 200C-E, that has been insertedinto the injection portal 211A-C, for identifying the medication in thesyringe. In some examples, short range RFID such as near field (NF) orhigh frequency (HF) may be advantageous because they will only detectthe syringe that is adjacent to or inside the medication identificationand measurement system 228A-C, and not detect the various othermedication syringes that may be sitting on the worktable.

As shown in FIGS. 44, 46, 48 the medication identification andmeasurement system 228A-C of this disclosure may include a RFIDinterrogator 238A-C. In some examples, the RFID interrogator 238A-C thatcan include antennas that may be located inside the medicationidentification and measurement system 228A-C. In some examples, the RFIDinterrogator 238A-C antennas may be located external to but proximatethe medication identification and measurement system 228A-C. As thesyringe (e.g., 200C, 200D, 200E) is brought into proximity of themedication identification and measurement system 228A-C, the RFIDinterrogator 238A-C interrogates the RFID tag 207 on the syringe 200,thereby accurately and reliably identifying a medication for IVadministration. In some examples, the RFID tag 207 may include one ormore of: the generic and brand name of the drug, the concentration, thelot number, the expiration date, the manufacturer and other importantinformation that may be recorded. In some examples, the generic andbrand name of the drug and the concentration of the drug can bedisplayed in the injection section of the display screen of theanesthetic record input component 224.

Machine vision is very accurate for measuring the size of an object at aknown distance or the distance of an object of known size. However, itcannot do both. Therefore, in some examples it is important to know theexact location of a syringe and thus know the distance from the camerato the syringe in order to accurately calculate the distance of themovement of the plunger within the syringe.

Syringes are available in multiple sizes such as 3 cc, 6 cc and 12 cc,each of which is a different diameter. The machine vision processor mustknow both the internal diameter of the barrel of the syringe and thedistance that the syringe plunger moves down the barrel, in order tocalculate the volume of medication injected. The machine vision of thisdisclosure can measure the diameter of the syringe because it is held inat known distance and in a centered location relative to the machinevision cameras 236A-C. Alternately, the automated EAR system 201 of thisdisclosure may be programed to know that the particular hospital usesonly Monoject® syringes for example and the internal diameter of eachMonoject® syringe size may be pre-programed into the computer. In thiscase, the machine vision only needs to differentiate 3 cc, 6 cc and 12cc syringe sizes from each other. The first step for the machine visionprocessor is to determine the internal diameter of the barrel of thesyringe.

In some examples, the machine vision system, including the machinevision camera and a processor 157 (e.g., processing circuitry) inelectrical communication with the machine vision camera can visuallydetect and determine other geometry information about the syringebesides the outside diameter, such as determining the inside diameter,or the inner or outer length of the syringe. The automated EAR system201 can use the geometry information to determine the size or type ofthe syringe, or can use the geometry information to calculate a volumeof the syringe.

In some examples, as the syringe 200 is advanced into the injectionportal 211A-C, the image of the syringe 200 entering the injectionportal 211A-C is displayed in real time in the injection section of thedisplay screen of the anesthetic record input component 224. Therefore,the caregiver can watch the syringe advance and engage with theinjection port 215A-C. In some examples, the injection portal tube 216Aor the spring positioning members 222A-E or the compression positioningmembers 242A,B, urge the syringe 200 into position to mate with theinjection port 215A-C but the actual connection can also be observed asit is happening by the caregiver on the display screen of the anestheticrecord input component 224. Even though the caregiver is not physicallyholding the injection port 215A-C as they typically would and are theycan watch the engagement of the Luer connector 213 with the injectionport 215A-C on a display screen, the view is essentially identical tothe thousands of injections that they have made during their career. Insome examples, the actual image of the syringe can be displayed on thedisplay screen 226, while in other examples the data obtained by thecamera can be converted to a representation of the syringe displayed onthe display screen 226.

In some examples, once the syringe 200 is securely connected to theinjection port 215A-C, the caregiver pushes on the plunger 246A-C of thesyringe 200C-E, injecting the medication into the injection port 215A-Cand IV tubing 220A-C. The caregiver can visualize the plunger seal248A-C move down the syringe barrel 218A-C and can determine the volumeof medication injected by the graduated markings on the syringe C-E.Thus, the engagement of the Luer connector 213 with the injection port215A-C and the injected volume are observed by the caregiver on thedisplay screen 226 of the anesthetic record input component 224 and thetraditional method and routine of injection is minimally altered by theEAR system 201 of this disclosure.

In some examples, the processing circuitry 157 or a computer may alsosimultaneously generate a running total of the volume and dosage of theinjected medication and display these numbers on the display screen 226of the anesthetic record input component 224. In some examples, theprocessing circuitry 157 or a computer may also simultaneously generateits own graduated scale and superimpose the scale on the image of thesyringe 200C-E or next to the image of the syringe 200C-E, for addedvisual clarity of the injected volume and dose.

In some examples, the machine vision determination of the injectedvolume may be calculated by multiplying the internal cross-sectionalarea of the syringe (πr²) by the distance that the syringe plungermoves. The radius of the syringe may be determined in one or more ways.For example, the machine vision function may determine that the syringeapproximates a 3 cc or 12 cc syringe and the computer is programed toknow that the hospital uses a specific brand of syringes and theinternal diameter (radius) of each of these syringe sizes is preciselyknown. Another example may require the machine vision to measure theouter diameter of the syringe and then subtract an approximated wallthickness from the measured diameter to determine the internal diameter.

In some examples, the machine vision determination of the distance thatthe syringe plunger moves may be by “observing” the movement of theblack rubber plunger seal against the visible scale printed on thesyringe. In this example, the machine vision is programed to recognizethe markings on the syringe.

In some examples, the machine vision determination of the distance thatthe syringe plunger moves may be by observing the movement of the blackrubber plunger seal relative to a scale calculated by the machine visioncomputer. The geometrical calculation of the scale that determines thedistance that the syringe plunger moves may be easiest along the widestpart of the syringe that corresponds with the center of the syringe,which is a known distance from the machine vision camera. Alternatively,the computer-constructed scale may be applied to the side of the syringefacing the camera, if the radius of the syringe is subtracted from theknown distance to the center of the syringe in order to calculate thedistance from the machine vision camera to the near side of the syringe.

In some examples, the movement of the black rubber plunger seal of thesyringe is clearly identifiable by the machine vision camera and a scaleto determine the distance moved by the plunger can either be“visualized” or constructed by the machine vision computer. Multiplyingthe distance that the plunger seal moves by the known or measuredinternal diameter of the syringe and thus cross-sectional area of theplunger seal, allows the processing circuitry 157 or an anestheticrecord input computer 203B (FIG. 42 ) in electrical communication withthe processing circuitry 157 to calculate an accurate injected volume.The anesthetic record input computer 203B may then display the measuredinjection volume and dosage on the display screen 226 of the anestheticrecord input component 224. Without interfering with or changing theanesthesiologists' normal or traditional medication injection routines,an unobtrusive machine vision camera and computer can “observe” themedication injections and automatically record them in the electronicanesthetic record.

In some examples, the injected volume of medication may be determined byother methods. For example, non-visual optical sensing is well known inthe arts. A light source shines on one or more light sensitive elementssuch as photodiodes for example, and the position of the plunger of thesyringe can be roughly determined by the obstruction of the light beamby the plunger. Other fluid measurement methods include adding magneticmaterial to the syringe plunger and detecting movement of the plungerwith a magnetic proximity sensor. Alternatively, fluid flow may bemeasured with fluid flow meters in the IV fluid stream. These examplesare not meant to be an exhaustive list but rather to illustrate thatthere are alternative technologies to machine vision, for noncontactmeasurement of fluid flow from a syringe that are anticipated in thisdisclosure.

Securing the injection port 215 within the injection portal 211 preventsthe caregiver from touching the injection port 215. Normally caregiverswear gloves to protect themselves from infectious contaminates from thepatient and operating room and their gloves are nearly alwayscontaminated. Anything they touch will be contaminated. They typicallypick up and hold the IV injection port 215A-C with one hand whileinserting the Luer taper connector 213 of the syringe 200 into theinjection port 215A-C. In the process, the injection port is frequentlycontaminated with pathogenic organisms from their gloves that can enterthe patient's blood stream with the next injection, causing seriousinfections. It is therefore advantageous from the infection preventionpoint of view, if the Luer connection and injection can be accomplishedwhile never touching the injection port 215A-C.

In some examples as shown in FIGS. 44, 46 and 48 the medicationidentification and measurement system 228A-C of this disclosure mayinclude one or more ultraviolet lights 240A-J that shine on theinjection port 215A-C. The one or more ultraviolet lights (UV) areinside the medication identification and measurement system 228A-C,keeping the injection portal 211A-C and the injection port 215A-Cdisinfected. In some examples, the ultraviolet lights 240A-J maypreferably be in the UV-C part of the spectrum. UV-C light has beenshown to have superior germicidal powers over other parts of the UVspectrum. The UV lights 240A-J may shine continuously or intermittently.By making the injection port 215A-C untouchable because it is inside themedication identification and measurement system 228A-C and radiatingthe injection port 215A-C with UV-C light, the injection port 215A-Cshould be effectively disinfected between each injection and eliminateinjection port contamination as a source of bloodstream infection.

In some examples as shown in FIG. 42 , a worktable 250 may be locatedproximate the head of the patient. In some examples, the worktable 250may be incorporated into relocation module 4210. In some examples, theworktable 250 may be used for holding the various medication syringes200F-H being used for the surgical anesthetic. In some examples, theLuer tapers 213 of the various medication syringes 200F-H are simplycapped in the traditional way while sitting on the worktable betweeninjections.

In some examples as shown in FIG. 42 , the various medication syringes200F-H are not capped between injections in order to prevent accidentalcontamination of the Luer tapers 213 by the contaminated fingers orgloves of the healthcare provider, during the capping process. In thisexample, the uncapped Luer tapers 213 of syringes 200F-H may be placedunder a protective overhang 252 that is 1-2.5 in. above and along therear of the worktable 250. In some examples, ultraviolet lights 240H maybe attached on the underside of the protective overhang 252, shiningdown on the exposed Luer tapers 213 of syringes 200F-H. In someexamples, the ultraviolet lights 240H are preferably in the UV-C part ofthe spectrum. Any of the UV lights 240A-J may shine continuously orintermittently.

In some examples, the uncapped Luer tapers 213 of syringes 200F-H arekept sterile by eliminating capping and thus not inadvertently touchingLuer tapers 213 of syringes 200F-H, and by storing the uncapped Luertapers 213 of syringes 200F-H under a protective overhang 252, and byradiating the uncapped Luer tapers 213 with UV-C light.

FIG. 50 illustrates an example injection port cassette that can be usedwith the system of FIG. 42 , as detailed in 45, 47 and 49. As shown inFIG. 50 , the injection port 215D may be mounted on an injection portcassette 254 in order to make the attachment to the medicationidentification and measurement system 228A-C easier and more secure. Theinjection port cassette 254 may be a piece of molded plastic onto whichthe injection port 215D and IV tubing 220 may be attached. The injectionport cassette 254 may be shaped and sized to fit into a slot in themedication identification and measurement system 228A-C. When theinjection port cassette 254 is fit into a slot in the medicationidentification and measurement system 228A-C, the injection port 215Dcan be positioned substantially in the center of the injection portal211 for mating with the Luer tapers 213. The injection port cassette 254can also be configured to be removed intact from the medicationidentification and measurement system 228A-C so that the patient can betransferred and the IV tubing 220 can be moved with the patient andcontinue to operate normally.

In some examples, and as shown in FIG. 50 , the injection port cassette254 can include an IV bypass channel 256 in the IV tubing 220. The IVbypass channel 256 can allow the IV fluids to flow unencumbered by themedication injection apparatus. The injection port cassette 254 caninclude a medication channel 258 in the IV tubing 220 and, themedication channel 258 may include one or more stop-flow clamps 260A, B.The stop-flow clamps 260A, B may be activated by anesthetic record inputcomponent 224 and anesthetic record computer if a medication error isnoted. The stop-flow clamps 260A, B may be powered by electromechanicalsolenoids that squeeze the IV tubing flat obstructing the flow. Otherelectromechanical flow obstructers are anticipated.

In some situations, such as when administering a drug to a patientallergic to that drug, or administering potent cardiovascular drugs to apatient with normal vital signs, or administering a drug with a likelymistaken identity, the automated anesthetic record computer of thisdisclosure may automatically activate the stop-flow clamps 260A, B tocompress the medication channel 258 tubing upstream and/or downstreamfrom the injection port 215D. Compressing the IV tubing both upstreamand downstream from the injection port 215D prevents the injection ofany medication into the IV tubing. An alert to the adverse condition ofthe injection may be displayed on the anesthetic record input component224, where the stop-flow condition can be over-ridden by the operatortouching a manual override switch on the anesthetic record inputcomponent 224, if the injection was not erroneous. While the stop-flowcan occur in the medication channel 258, the IV fluid flow can continuenormally in the parallel bypass channel 256.

The stop-flow clamps 260A, B can allow the microprocessor (e.g.,processor, hardware processing circuitry) of the anesthetic record inputcomponent 224 to not only warn the operator of a pending medicationerror, but physically prevent the injection. Equally important is thatthe stop-flow clamps 260A, B can be quickly released by the operatortouching a manual override switch in the event that the apparent errorwas in fact a planned event.

FIG. 51 illustrates a side view of an example IV fluid identificationand measurement system 230 that can be used with the systems of FIG.42-49 , and injection port cassette of FIG. 50 . In some examples, theautomated EAR of this disclosure includes a system for automaticallymeasuring and recording the administration of IV fluids. As shown inFIGS. 42 and 51 , the automated EAR 201 can include an IV fluididentification and measurement system 230. In some examples, the IVfluid identification and measurement system 230 can be mounted ontomodule 4210. Alternately, the IV fluid identification and measurementsystem 230 may be mounted to an IV pole or racking system independentfrom the module 4210. The system for automatically measuring andrecording the administration of IV fluids is not limited to use inanesthesia or in the operating room, but has applicability for usethroughout the hospital and other health care settings, including butnot limited to the ICU, ER, wards, rehabilitation centers and long termcare settings.

In some examples, the IV fluid identification and measurement system 230may be configured to accommodate one or more IV bags of IV fluid 232A,B. Each bag of IV fluid can include a drip chamber 234A, B and IV tubing220D, E. IV flow rates may be controlled with the traditional manuallyoperated roller clamp that variably pinches the IV tubing 220D, E tocontrol or even stop the flow of IV fluids. In some examples, IV flowrates may be controlled with the automatically operatedelectromechanical flow rate clamps 278 that variably pinch the IV tubing220D to control or even stop the flow of IV fluids. The automaticallyoperated electromechanical flow rate clamps 278 may be controlled by theelectronic anesthetic record computer in module 4210 or by amicroprocessor (e.g., processor, hardware processing circuitry) locatedwithin the IV fluid identification and measurement system 230.

In some examples, the system for automatically measuring and recordingthe administration of IV medications and fluids 228, 230 includes one ormore of a barcode reader and an RFID interrogator (such as 236D, E) foraccurately and automatically identifying a fluid for IV administration.Because of the close proximity to the adjacent bags, barcodeidentification may be preferable in order to prevent an RFIDinterrogator from reading the RFID tag on a neighboring bag. In someexamples, as shown in FIG. 51 , one or more barcode labels 205B, C maybe applied to the IV bags 232A, B in a location where they can be readby a barcode reader or machine vision camera 236D, E, or another machinevision camera located in a suitable position. In some examples, adedicated barcode reader or a machine vision camera may be positionedadjacent the barcode label 205B, C location, specifically for readingthe barcode label 205B, C.

In some examples, the drip chamber 234A, B of the IV set can bepositioned adjacent the one or more machine vision cameras 236D, E. Insome examples, a standard background 268A, B may be positioned on theopposite side of the drip chamber 234A, B from the machine visioncameras 236D, E. The standard background 268A, B may be a plainbackground or may be an advantageous color, pattern, color design orillumination that highlights each of the falling drops, for easieridentification by the machine vision software. The machine visionsoftware can include one or more machine-readable mediums that whenimplemented on hardware processing circuitry of the system or inelectrical communication with the system, can perform the functionsdescribed herein.

In some examples, the machine vision software is programed to cause theprocessing circuitry 157 to look for a fluid meniscus 264A, B in thedrip chamber 234A, B. In this case “seeing” a fluid meniscus 264A, Bindicates that there is fluid in the drip chamber 234A, B and thereforethe IV bag 232A, B is not empty, and air is not inadvertently enteringthe IV tubing.

In some examples, if the machine vision software fails to “see” a fluidmeniscus 264A, B meaning that the drip chamber 234A, B is empty and thusthe IV bag 232A, B is empty, stop-flow clamps 260C, D may beautomatically activated to compress the IV tubing 220D, E in order toprevent air from entering the IV tubing 220D, E. In some examples, theempty IV bag condition detected by the machine vision software can bedisplayed as an alert to the caregiver on the anesthetic record inputcomponent 224.

The combination of the machine vision camera 236D, 236E in electricalcommunication with processing circuitry (e.g., 157, FIGS. 1 and 42 ,processor 3304, FIG. 33 ) can count the number of drops of fluid perunit of time in a drip chamber 234A, B to calculate or to estimate theflow rate of an IV. The size of the drip chamber inlet orificedetermines the volume of liquid in each drop. The inlet orifices ofstandard drip chambers are sized to create drops sizes that result in10, 12, 15, 20, 45 and 60 drops per ml. Given a particular drop volume(size), 10 drops per ml for example, the system can count the number ofdrops falling in a known period of time and use that data to calculateor to estimate the flow rate. If these estimates were attempted by ahuman, they may be less accurate at higher flow rates (higher dropcounts) because the drops are so fast, it can be difficult to count thedrops. Eventually, at even higher flow rates the individual drops becomea solid stream of fluid and the flow rate cannot be visually estimated.

In some examples, the machine vision system is configured to look forfalling drops of fluid 262A, B within the drip chamber 234A, B. Whendrops have been identified, the machine vision system (e.g., machinevision camera 236D or 236E operably coupled to processing circuitry 157)may first measure the diameter of the drop to determine which of thestandard drop sizes or volumes it is counting. Most hospitalsstandardize on several infusion set sizes, 10, 20 and 60 drops per ccfor example. Therefore, when these limited choices of infusion setbrands and sizes have been programed into the computer, the machinevision system only needs to differentiate between these choices, whichis much easier than accurately measuring the diameter of the drops.Unlike the human eye, the machine vision can accurately count thefalling drops even at high flow rates to calculate an IV fluid flowrate.

In some examples, the machine vision system, including the machinevision cameras 236D, E and the machine vision software implemented byhardware processing circuitry 157 does not “see” falling drops. In thissituation, either the fluid is flowing in a steady stream that is notidentifiable by the machine vision software or the fluid has stoppedflowing. In some examples, these two opposite conditions can bedifferentiated by inserting a floating object 266A, B into the dripchambers 234A, B. In some examples, the floating object 266A, B may be aball-shaped float 266A, B and in some examples the float may bepatterned or multi-colored to more easily identify movement or spinningof the float. In some examples, if the machine vision system cannotidentify falling drops, it then looks to the floating object 266A, B foradditional information. If the floating object 266A, B is not moving orspinning, the fluid flow has stopped. If the float 266A, B is moving orspinning and drops cannot be identified, the fluid is flowing in asteady stream and the flow rate cannot be measured by machine vision.

In some examples, the IV fluid identification and measurement system 230may be configured to accommodate one or more bags of IV fluid 232A, Band each of these IV bags may be hanging from an electronic IV scale272A, B. The electronic IV scale 272A can measure the combined weight ofthe IV bag and fluid 232A, the drip chamber 234A and the IV tubing 220D.The electronic IV scale 272B can measure the weight or combined weightof one or more of the IV bag and fluid 232B, the drip chamber 234B, theIV tubing 220E and the pressure infuser 274. In both of these examples,the electronic IV scale 272A, B can accurately measure the change incombined weight that occurs due to the drainage of the IV fluid from theIV bag. The change in weight per unit time can be converted to flowrates by processing circuitry 157 in electrical communication with theelectronic IV scale 272A, 272B, for example, by the anesthetic recordcomputer 203B and displayed on the anesthetic record input component224.

In some examples, the calculated flow rates for each IV bag 232A, B mayalso be displayed on one or more digital flow-rate displays 276A, Bmounted on the IV fluid identification and measurement system 230. Thedigital flow-rate displays 276A, B may be small LED or LCD displayscreens that conveniently tell the operator the flow rate while they aremanually adjusting the flow rate near the IV bags 232A, B and dripchambers. 234A, B. The digital flow-rate displays 276A, B areparticularly convenient when the IV fluid identification and measurementsystem 230 is a free standing entity mounted on an IV pole for examplewhile being used on the ward or ICU.

In some examples, when the falling drops 262A, B cannot be detected andyet the floats 266A, B are moving or spinning, the fluid is determinedto be flowing in a steady stream and the flow rate cannot be measured bymachine vision. In this case the anesthetic record computer mayautomatically query the change in weight per unit time as measured bythe electronic IV scale 272A, B to determine the IV flow rate. At highflow rates, the change in weight per unit time as measured by theelectronic IV scale 272A, B will most likely be more accurate thancounting drops, in determining the IV flow rate.

The IV flow rate as determined by the change in weight per unit time canalso be compared to the IV flow rates determined by counting drops toverify the accuracy of each method. Without interfering with or changingthe anesthesiologists' normal or traditional IV routines, an unobtrusivemachine vision camera and computer can “observe” the IV flow rates andautomatically record them in the electronic anesthetic record.

FIG. 52 illustrates side view of an example of a gas flow meter system289 that can be used with the system of FIG. 42 . FIG. 53 illustrates atop view of the example gas flow meter system 289 of FIG. 52 . FIG. 54illustrates a side view of an example anesthetic gas vaporizermonitoring system including a vaporizer 288 that can be used with thesystem of FIG. 42 .

Some ventilation gas flow meters on anesthesia machines are made byfloating a small metal float in a gas stream flowing through a glasstube. The inside of the glass tube is tapered from narrow at the bottomto wider at the top, thus requiring higher flow rates to raise the floathigher in the glass tube. As shown in FIGS. 52, 53 , the gas flow metertubes 280A, B have floats 282A, B suspended by the gas flow within thetubes 280A, B. The gas flow in each gas flow meter tube 280A, B iscontrolled by the flow control valves 286A, B. The height of thefloating effect correlates with the flow rate of the gas within the tubeand can be measured by comparing the height of the floats 282A, B to thegas flow rate scales 284A, B located adjacent the flow meter tubes 280A,B. In these examples, float 282A indicates approximately 3.5 li/min ofgas flow and float 282B indicates approximately 2 li/min of gas flow.

In some examples, the automated EAR system 201 of this disclosure canuse machine vision to unobtrusively “observe” the flow rate of theventilation gas flow meters (e.g., 289; FIG. 42, 52, 53 ). In someexamples, the machine vision camera 236D is located far enough from thegas flow meter tubes 280A, B to have a “view” of the entire tube. Thecamera 236D and computer can differentiate the float 282A, B from thebackground and accurately locate float 282A, B within the gas flow metertubes 280A, B. The machine vision computer is programed with a scalethat corresponds to the gas flow rate scales 284A, B. Comparing float282A, B locations with the scale programed into the computer, accuratelydetermines the gas flow rate within the gas flow meter tubes 280A, B.Without changing or interfering with the anesthesiologists' normal ortraditional gas control routines, an unobtrusive machine vision cameraand computer can “observe” the gas flow rates and generate data that isautomatically recorded in the electronic anesthetic record, or used tocalculate other data that is recorded (e.g., stored) in the electronicanesthetic record 203A.

In some examples, the automated EAR system 201 of this disclosure usesmachine vision to unobtrusively “observe” the concentration of theanesthetic gas from the anesthetic gas vaporizer. As shown in FIG. 54 ,the anesthetic gas vaporizer 288 can include a canister with a rotatingvaporizer control knob 290 used to adjust the concentration of theanesthetic gas flowing from the vaporizer 288. For example, the controlknob 290 can be located on the top of the vaporizer 288, but otherconfigurations such as locating the control knob 290 on the side of thevaporizer 288 are possible. In some examples, a machine vision camera236E is positioned on the anesthesia machine or on the module 4210 sothat it can “see” either the numerical scale printed on the control knob290 or a scale programed into the computer that corresponds to thenumerical scale printed on the control knob 290. The machine visioncamera and computer can accurately determine the concentration ofdelivered anesthetic gases. Without changing or interfering with theanesthesiologists' normal or traditional anesthetic gas controlroutines, an unobtrusive machine vision camera and computer can“observe” the anesthetic gas flow concentrations and automaticallyrecord them in the electronic anesthetic record.

In some examples, the automated EAR system 201 of this disclosureaccepts data from the electronic scales and hematocrit determinations ofthe fluid suction canisters or bags disclosed herein. The calculatedblood loss is automatically recorded in the EAR 203A and displayed onthe anesthetic record input component 224 and the electronic anestheticrecord display 226.

In some examples, the automated EAR system 201 of this disclosure is inelectrical communication with and is configured to accept (e.g.,receive) data from the electronic urine bag scales disclosed herein. Thecalculated urine output can be automatically recorded in the EAR 203Aand displayed on the anesthetic record input component 224 and theelectronic anesthetic record display 226.

In some examples, the automated EAR system 201 of this disclosure is inelectrical communication with and is configured to receive data from anIV extravasation monitor that is either hard wired or wirelesslyconnected to the patients' IV site. An IV extravasation monitor can bedesigned to detect inadvertent leakage from the IV site into thesurrounding tissue, which generally means that the IV is “blown” andsome infused drugs could cause significant tissue damage. One example ofan IV extravasation monitor previously disclosed by this inventorincludes the placement of one or more thermometers (thermocouples orthermistors) adjacent the IV catheter entrance site into the vein andadjacent the tip of the IV catheter. A thermometer is programed tocontinuously measure the temperature difference (ΔT) between these twosites. If the ΔT changes over time, it can be assumed that leakage ofcool or warm IV fluids is occurring at either the catheter entrance siteinto the vein or that the tip of the catheter has eroded through thevein wall. The cool IV fluids will cool the tissue and the adjacentthermometer will detect a cooling of the tissue at that site. When anincreasing temperature differential is detected, an alarm will beactivated and the automated EAR 203A of this disclosure will benotified.

In some examples, the automated EAR system 201 of this disclosure is inelectrical communication with and is configured to receive data from apatient support mattress. In some examples, the patient support mattressis an air mattress. One example of a patient support air mattress isdisclosed in U.S. Pat. Nos. 9,962,122 and 10,433,792, incorporated intothis disclosure in their entirety. The air mattress may include an airpressure sensor to detect the air pressure within the air chambers ofthe system. The first requisite is that the patient support mattress isnot “hammocking,” in other words that the upper surface is not stretchedtight enough to prevent the body part from sinking into the airmattress. The second requisite is that a body part is not “bottomingout” on the hard surface below the patient support mattress. The thirdrequisite is that the air chambers are partially inflated in order toallow the patient to sink into the mattress. If these three requisitesare satisfied, the pressure per square area of skin cannot be greaterthan the pressure per square area within the air chamber, which is thedefinition of the measured air pressure within the air chamber. Thisskin pressure safety monitor is both simple and inexpensive and moreaccurate compared to other electronic pressure detection systems foravoiding pressure injuries.

In some examples, when the patient is sunk into the patient support airmattress disclosed in U.S. Pat. Nos. 9,962,122 and 10,433,792, the airpressure within the air chambers may be measured and recorded. If themeasured air pressure per square area is less than the capillaryperfusion pressure of the skin, it can be assumed that there are noareas of the patient's skin where blood flow has been occluded bypressure from the support mattress. In other words, if the requisitecriteria listed above are satisfied, the air pressure in the airchambers of the mattress serves as a reliable monitor of the maximumpressure applied to any dependent skin surface. This air pressure can beautomatically recorded in the EAR 203A and displayed on the anestheticrecord input component 224 and the electronic anesthetic record display226, providing assurance to the caregiver and documentation that thepatient's skin has been adequately protected from pressure injury.

In some examples, the automated EAR of this disclosure is in electricalcommunication with and is configured to receive data from a system forautomatically counting and detecting surgical sponges. A system forautomatically counting and detecting surgical sponges has beenpreviously disclosed in US Patent Application 2015/0216610 and U.S. Pat.No. 10,461,397 which are incorporated into this disclosure in theirentirety. These disclosures by this inventor describe a system ofincorporating RFID tags into surgical sponges. Each of the RFID tags andthus each of the sponges is interrogated as the sponges enter thesterile surgical field and each is individually recorded. Later, each ofthe sponges is interrogated as the sponges leave the sterile surgicalfield and each is individually recorded. This electronic RFID spongecounting is presumably more accurate and reliable than the manual spongecount by the nurse. If a discrepancy is noted in the sponge count, RFIDantennae may be used to detect the location of the missing sponge, evenif it is still in the patient.

In some examples, the data from the RFID sponge counting isautomatically entered into the EAR 203A or electronic surgical record.An accurate sponge count can assure the care providers that a “retainedsurgical item” has not occurred. The itemized sponge count also aids ininventory management and billing.

In some examples, the automated EAR system 201 of this disclosure is inelectrical communication with and is configured to receive data from aSequential Compression Device (SCD) that may be housed within module1410. An SCD is an inflatable leg wrap that sequentially appliespressure to the legs of a patient during surgery in order to preventdeep vein thrombosis (DVT). The use of the SCD and the applied airpressures may be automatically entered into the EAR 203A or electronicsurgical record. Documentation that SCD was used during surgery alsoaids in inventory management and billing.

In some examples, the automated EAR system 201 of this disclosure is inelectrical communication with and is configured to receive data from anElectrosurgical Unit (ESU) that may be housed within module 1410. TheESU use history and settings may be automatically entered into the EAR203A or electronic surgical record. Documentation that SCD was usedduring surgery also aids in inventory management and billing.

In some examples, the automated EAR system 201 of this disclosure is inelectrical communication with and is configured to receive data from aperitoneal insufflator that may be housed within module 1410. Peritonealinsufflators are used to insufflate the patient's peritoneum duringlaparoscopic and robotic surgery. The insufflator use history andpressure settings may be automatically entered into the EAR 203A orelectronic surgical record. Documentation that insufflator was usedduring surgery also aids in inventory management and billing.

When the aforementioned data has been automatically recorded into theEAR 203A, documentation steps by the healthcare providers is drasticallysimplified. In some examples, the only remaining items in need ofdocumentation are the special events such as intubation, extubation,surgical incision, going on bypass, going off bypass and surgicalmishaps.

In some examples, the automated EAR system 201 of this disclosurecaptures anesthetic event data by capitalizing on the fact thatanesthesiologists, surgeons and nurses compulsively tend to meticulouslyfollow their personal routines. For each “event” they will inevitablyfollow their routine and use the same description each time to recordthe event. For example, a particular anesthesiologist may routinelyintubate all adult male patients with a Miller 3 laryngoscope and an 8.0endotracheal tube unless there is an abnormality. The provider's routinewritten record of the event may state, “Miller 3, 8.0 ET taped 23 cm atteeth, atraumatic, BBS” and that provider will write the samedescription every time. The provider has done a thousand of theseintubations and believes their way is best and therefore there is noneed for experimentation or unique descriptive procedure notes. Thisobservation of routine applies to surgeons as well— both in the detailsof each surgical procedure and the dictated surgical note describing thesurgical procedure. Therefore, the automatic EAR 203A, or EAR computer203B can be programed to “automatically” document most procedures andspecial events if it knows who the provider is and a few facts about thepatient.

For example, if the EAR system 201 knows who is providing theanesthesia, knows their preferences, knows how they prefer to describeanesthesia events such as intubation and knows that the patient is anadult male, it can “automatically” enter anesthesia providers' standarddescription of the intubation event into the record and will be correctmore than 95% of the time. Therefore, the anesthesia provider simplyindicates on the anesthetic record input component 224 that intubationoccurred by touching the intubation icon and the event will beautomatically recorded and the time noted. In the unusual event of apatient abnormality or a deviation from their normal routine, theanesthesia provider can manually enter the variant information, toprovide an accurate record. In some examples, the relative rarity ofdata being manually entered into the EAR 203A allows for the eliminationof the computer keyboard and mouse, to be replaced by an easy-to-cleantouch screen display.

The automated EAR system 201 of this disclosure captures anestheticevent data but it must be noted that the same technologies describedherein for capturing anesthetic event data can be used throughout thehospital or outpatient health care system to capture and recordmedication administration, IV fluid administration, vital signs andpatient monitor inputs, provider events and other data. Non-operatingroom heath care locations are intended to be included within the scopeof this disclosure. While this disclosure focuses on the totality offunctions offered by module 10, 1410, each of the individual functionscan be offered independently of module 10, 1410.

The use of the term Electronic Anesthetic Record as defined herein caninclude an electronic surgical record, or an electronic medical record,and is not limited to anesthetic or surgical applications. Aspects ofthe modules described herein can also be employed in recovery, hospitalroom and long-term care settings.

In an example, the module 4210 of FIGS. 42-54 , like module 10 of FIG. 1, can include a housing having a lower section 14 and a tower-like uppersection 18, wherein the lower section 14 is configured to houseunrelated waste heat-producing electronic and electromechanical surgicalequipment, and wherein the tower-like upper section is located on top ofthe lower section. The module 4210 can also include a cowling thatsubstantially confines waste heat generated by the unrelated wasteheat-producing electronic and electromechanical surgical equipment. Inaddition, the module 4210 can include a system for monitoring theadministration of one or more IV medications and fluids 228, 230. Thesystem 228, 230 can include: a barcode reader or an RFID 238interrogator configured to identify the one or more IV medications orfluids; a machine vision digital camera 236 to capture an image of oneor more of a syringe 200 or a drip chamber 234; processing circuitry 157(3304, FIG. 33 ) operably coupled to the barcode reader 236 or the RFIDinterrogator 238 to receive the identity of the one or more IVmedications or fluids, the processing circuitry 157 operably coupled tothe machine vision digital camera to receive the captured image anddetermine a volume of medication administered from the syringe or fluidadministered from an IV bag based on the image; and a display 226operably coupled to the processing circuitry 157, the display 226configured to receive instructions from the processing circuitry 157 tooutput the identity and determined volume of medication administeredfrom the syringe or fluid administered from an IV bag.

The above detailed description includes references to the accompanyingdrawings, which form a part of the detailed description. The drawingsshow, by way of illustration, specific embodiments in which theinvention can be practiced. These embodiments are also referred toherein as “examples.” Such examples can include elements in addition tothose shown or described. However, the present inventors alsocontemplate examples in which only those elements shown or described areprovided. Moreover, the present inventors also contemplate examplesusing any combination or permutation of those elements shown ordescribed (or one or more aspects thereof), either with respect to aparticular example (or one or more aspects thereof), or with respect toother examples (or one or more aspects thereof) shown or describedherein.

In this document, the terms “a” or “an” are used, as is common in patentdocuments, to include one or more than one, independent of any otherinstances or usages of “at least one” or “one or more.” In thisdocument, the term “or” is used to refer to a nonexclusive or, such that“A or B” includes “A but not B,” “B but not A,” and “A and B,” unlessotherwise indicated. In this document, the terms “including” and “inwhich” are used as the plain-English equivalents of the respective terms“comprising” and “wherein.” Also, in the following claims, the terms“including” and “comprising” are open-ended, that is, a system, device,article, composition, formulation, or process that includes elements inaddition to those listed after such a term in a claim are still deemedto fall within the scope of that claim. Moreover, in the followingclaims, the terms “first,” “second,” and “third,” etc. are used merelyas labels, and are not intended to impose numerical requirements ontheir objects. The terms approximately, about or substantially aredefined herein as being within 10% of the stated value or arrangement.

The above description is intended to be illustrative, and notrestrictive. For example, the above-described examples (or one or moreaspects thereof) may be used in combination with each other. Otherexamples can be used, such as by one of ordinary skill in the art uponreviewing the above description. The Abstract is provided to allow thereader to quickly ascertain the nature of the technical disclosure. Itis submitted with the understanding that it will not be used tointerpret or limit the scope or meaning of the claims. Also, in theabove Detailed Description, various features may be grouped together tostreamline the disclosure. This should not be interpreted as intendingthat an unclaimed disclosed feature is essential to any claim. Rather,inventive subject matter may lie in less than all features of aparticular disclosed example. Thus, the following claims are herebyincorporated into the Detailed Description as examples or examples, witheach claim standing on its own as a separate example, and it iscontemplated that such examples can be combined with each other invarious combinations or permutations. The scope of the invention shouldbe determined with reference to the appended claims, along with the fullscope of equivalents to which such claims are entitled.

Notes and Various Examples

Each of these non-limiting examples may stand on its own, or may becombined in various permutations or combinations with one or more of theother examples. The examples are supported by the preceding writtendescription as well as the drawings of this disclosure.

Example Set 1

Example 1 is a method of vacuuming air in an operating room, the methodcomprising: receiving, using circuitry, one or more instructions toprovide power to a fan disposed in a surgical module, wherein thehousing is configured to store unrelated electronic andelectromechanical surgical equipment within the housing; and providingpower to the fan, using the circuitry, wherein providing power to thefan causes air from a surgical field to be collected into a plenumthrough an inlet vent, and causes heat generated by the electronicsurgical equipment to be collected into the plenum, wherein providingpower to the fan causes the collected air and heat to create an airflowthat passes through a specified channel in the housing, and wherein thecontrolled airflow causes the equipment stored in the module to becooled and the airflow to be cleaned before being exhausted out of thehousing through an outlet vent.

In Example 2, the subject matter of Example 1 includes, whereinreceiving the one or more instructions, using the circuitry, includesreceiving an instruction to actuate a noise canceling device, whereinthe noise canceling device is configured to cancel at least a portion ofa noise generated by the fan.

In Example 3, the subject matter of Examples 1-2 includes, wherein theplenum substantially separates the air collected through the inlet ventfrom being in contact with the electronic and electromechanicalequipment.

In Example 4, the subject matter of Examples 1-3 includes, wherein thecircuitry includes processing circuitry, the method further comprising:receiving an instruction, using the processor, to divert at least aportion of the airflow to an air mattress; and sending an instruction,using the processor, to a flow management device to divert at leastportion of the airflow to the air mattress; and diverting, using theflow management device, at least a portion of the airflow to the airmattress.

In Example 5, the subject matter of Examples 1-4 includes, wherein thecircuitry includes a processor, the method further comprising: sensing,using a sensor, information related to an air mattress; receiving, usingthe processor, the information from the sensor; determining, using theprocessor and the information received from the sensor, to divert atleast a portion of the airflow to the air mattress; and sending aninstruction; using the processor, to a flow management device to divertat least a portion of the airflow to the air mattress.

In Example 6, the subject matter of Example 5 includes, whereindetermining, using the processor, to divert at least a portion of theairflow to the air mattress includes determining that the informationsensed by the sensor has traversed a threshold.

In Example 7, the subject matter of Examples 1-6 includes, wherein thecircuitry includes a processor, the method further comprising: receivingan instruction, using the processor, to divert at least a portion of theairflow to a compression device; and sending an instruction, using theprocessor, to a flow management device to divert at least portion of theairflow to the compression device; and diverting, using the flowmanagement device, at least a portion of the airflow to compressiondevice.

In Example 8, the subject matter of Examples 1-7 includes, wherein thecircuitry includes a processor, the method further comprising: sensing,using a sensor, information related to a compression device; receiving,using the processor, the information from the sensor; determining, usingthe processor and the information received from the sensor, to divert atleast a portion of the airflow to the compression device; and sending aninstruction; using the processor, to a flow management device to divertat least a portion of the airflow to the compression device.

In Example 9, the subject matter of Example 8 includes, whereindetermining, using the processor, to divert at least a portion of theairflow to the air mattress includes determining that the informationsensed by the sensor has traversed a threshold.

In Example 10, the subject matter of Examples 1-9 includes, sensing,using a sensor, a pressure in the specified channel, receiving, usingthe processor, the pressure; determining, using the processor, that thepressure has traversed a threshold, and if the pressure has traversedthe threshold, adjusting, using the processor, an output of the fan.

In Example 11, the subject matter of Examples 1-10 includes, wherein thehousing comprises a heat-resistant cowling.

Example 12 is at least one non-transitory machine-readable mediumincluding instructions for vacuuming air in an operating room, whichwhen executed by processing circuitry, cause the processing circuitry toperform operations comprising: receiving one or more instructions toprovide power to a fan disposed in a surgical module, wherein thehousing is configured to store unrelated electronic andelectromechanical surgical equipment within the housing; providing powerto the fan, wherein providing power to the fan causes air from asurgical field to be collected into a plenum through an inlet vent, andcauses heat generated by the electronic surgical equipment to becollected into the plenum, wherein providing power to the fan causes thecollected air and heat to create an airflow that passes through aspecified channel in the housing, and wherein the controlled airflowcauses the equipment stored in the module to be cooled and the airflowto be cleaned before being exhausted out of the housing through anoutlet vent.

In Example 13, the subject matter of Example 12 includes, wherein theprocessing circuitry is further configured to perform operations to:receive the one or more instructions including an instruction to actuatea noise canceling device, wherein the noise canceling device isconfigured to cancel at least a portion of a noise generated by the fan.

In Example 14, the subject matter of Examples 12-13 includes, whereinthe plenum substantially separates the air collected through the inletvent from being in contact with the electronic and electromechanicalequipment.

In Example 15, the subject matter of Examples 12-14 includes, whereinthe processing circuitry is further configured to perform operations to:receive an instruction to divert at least a portion of the airflow to anair mattress; and send an instruction to a flow management device todivert at least portion of the airflow to the air mattress; and divertat least a portion of the airflow to the air mattress.

In Example 16, the subject matter of Examples 12-15 includes, whereinthe processing circuitry is further configured to perform operations to:sense, using a sensor, information related to an air mattress; receive,using the processor, the information from the sensor; determine, usingthe processor and the information received from the sensor, to divert atleast a portion of the airflow to the air mattress; and send aninstruction; using the processor, to a flow management device to divertat least a portion of the airflow to the air mattress.

In Example 17, the subject matter of Example 16 includes, whereindetermining to divert at least a portion of the airflow to the airmattress includes determining that the information sensed by the sensorhas traversed a threshold.

In Example 18, the subject matter of Examples 12-17 includes, whereinthe processing circuitry is further configured to perform operations to:receive an instruction to divert at least a portion of the airflow to acompression device; and send an instruction to a flow management deviceto divert at least portion of the airflow to the compression device; anddivert, using the flow management device, at least a portion of theairflow to compression device.

In Example 19, the subject matter of Examples 12-18 includes, whereinthe processing circuitry is further configured to perform operations to:sense, using a sensor, information related to a compression device;receive the information from the sensor; determine from the receivedinformation, to divert at least a portion of the airflow to thecompression device; and send an instruction to a flow management deviceto divert at least a portion of the airflow to the compression device.

In Example 20, the subject matter of Example 19 includes, whereindetermining to divert at least a portion of the airflow to the airmattress includes determining that the information sensed by the sensorhas traversed a threshold.

In Example 21, the subject matter of Examples 12-20 includes, whereinthe processing circuitry is further configured to perform operations to:sense using a sensor, pressure information related to a pressure in thespecified channel, receive the pressure information; determine that thepressure has traversed a threshold, and if the pressure has traversedthe threshold, adjust an output of the fan.

In Example 22, the subject matter of Examples 12-21 includes, whereinthe housing comprises a heat-resistant cowling.

Example 23 is at least one machine-readable medium includinginstructions that, when executed by processing circuitry, cause theprocessing circuitry to perform operations to implement of any ofExamples 1-22.

Example 24 is an apparatus comprising means to implement of any ofExamples 1-22.

Example 25 is a system to implement of any of Examples 1-22.

Example 16 is a method to implement of any of Examples 1-12.

Example Set 2

Example 1 is a method of reducing germs in an operating room, the methodcomprising: determining, using a processor, to activate a disinfectionsystem based on a disinfection time stored on a memory; and sendinginstructions, based on the disinfection time, to turn on thedisinfection system, wherein the disinfection system is located at a topend portion of a housing having electronic and electro-mechanicalmedical equipment disposed therein.

In Example 2, the subject matter of Example 1 includes, wherein thedisinfection system includes UV-C lights configured to shine outward andor downward from the top end portion of the housing, and wherein turningon the disinfection system includes turning on the UV-C lights.

In Example 3, the subject matter of Examples 1-2 includes, sendinginstructions based on the disinfection time, using the processor, toactuate an electro-mechanical mechanism configured to deploy thedisinfection system, wherein when the electro-mechanical mechanism isactuated, the disinfection system is caused to move in a directionoutward from the housing.

In Example 4, the subject matter of Example 3 includes, sendinginstructions based on an end disinfection time, using the processor, toactuate the electro-mechanical mechanism to retract the disinfectionsystem, wherein when the electro-mechanical mechanism is retracted, thedisinfection system is caused to move in a direction towards thehousing.

In Example 5, the subject matter of Examples 1-4 includes, receivingfrom motion sensor, using the processor, information about motion in themedical setting around the housing and preventing actuation, or turningoff the disinfection system if motion is sensed within a specifiedrange.

In Example 6, the subject matter of Examples 1-5 includes, whereinsending instructions, based on the disinfection time, to turn on thedisinfection system, includes turning on a second disinfection systemlocated closer to a bottom end portion of the housing, wherein thebottom end portion is opposite the top end portion.

Example 7 is at least one non-transitory machine-readable mediumincluding instructions for reducing germs in an operating room, whichwhen executed by processing circuitry, cause the processing circuitry toperform operations comprising: activate a disinfection system, based ona disinfection time stored on a memory; and turn on the disinfectionsystem, wherein the disinfection system is located at a top end portionof a housing having electronic and electro-mechanical medical equipmentdisposed therein.

In Example 8, the subject matter of Example 7 includes, wherein thedisinfection system includes UV-C lights configured to shine outward andor downward from the top end portion of the housing, and wherein turningon the disinfection includes turning on the UV-C lights.

In Example 9, the subject matter of Examples 7-8 includes, sendinginstructions to actuate an electro-mechanical mechanism configured todeploy the disinfection system, based on the disinfection time, whereinwhen the electro-mechanical mechanism is actuated, the disinfectionsystem is caused to move in a direction outward from the housing.

In Example 10, the subject matter of Example 9 includes, sendinginstructions to actuate the electro-mechanical mechanism to retract thedisinfection system, based on an end disinfection time, wherein when theelectro-mechanical mechanism is retracted, the disinfection system iscaused to move in a direction towards the housing.

In Example 11, the subject matter of Examples 7-10 includes, receivingfrom a motion sensor, information about motion in the medical settingaround the housing, and preventing actuation, or turning off thedisinfection system if motion is sensed within a specified range.

In Example 12, the subject matter of Examples 7-11 includes, whereinsending instructions, based on the disinfection time, to turn on thedisinfection system, includes turning on a second disinfection systemlocated closer to a bottom end portion of the housing, wherein thebottom end portion is opposite the top end portion.

Example 13 is at least one machine-readable medium includinginstructions that, when executed by processing circuitry, cause theprocessing circuitry to perform operations to implement of any ofExamples 1-12.

Example 14 is an apparatus comprising means to implement of any ofExamples 1-12.

Example 15 is a system to implement of any of Examples 1-12.

Example 16 is a method to implement of any of Examples 1-12.

Example Set 3

Example 1 is a method of monitoring waste fluid during a surgery, themethod comprising: receiving from a sensor, using a processor,information about an amount of a waste fluid collected in a waste fluidstorage device, wherein the information includes, a first fluid amountmeasured at a first time and a second fluid amount measured at a secondtime; determining, using the processor, a delta between the first fluidamount and the second fluid amount, using the information; outputtingthe delta, using the processor, to display the delta on an electronicdevice, wherein the electronic device is coupled to a housing configuredto store unrelated waste-heat producing electronic and electromechanicalsurgical equipment; and saving, using the processor, to a storage devicehaving at least a portion of a patient's anesthetic record storedthereon, at least a portion of the information.

In Example 2, the subject matter of Example 1 includes, wherein theamount of waste fluid is a weight of the waste fluid.

In Example 3, the subject matter of Examples 1-2 includes, receivingfrom a second sensor, using the processor, information about a volume ofblood in the waste fluid storage device; receiving from a third sensor,using the processor, information about a concentration of a bloodcharacteristic in the waste fluid; receiving, from a memory, using theprocessor, information about a concentration of a blood characteristicin the patient prior to the surgery; determining an amount of blood inthe waste fluid, using the processor, wherein determining the amount ofblood in the waste fluid is determined by dividing the information abouta concentration of a blood characteristic in the waste fluid by theinformation about a concentration of a blood characteristic in a patientprior to the surgery to establish a concentration ratio, and multiplyingthe concentration ratio by the information about a volume of blood inthe waste fluid storage device; and outputting the amount of blood inthe waste fluid, using the processor, to display the amount of blood inthe waste fluid on the electronic device.

In Example 4, the subject matter of Example 3 includes, wherein theinformation about the volume of blood in the waste fluid storage deviceincludes a correction to ignore a volume of foam in the waste fluidstorage device.

In Example 5, the subject matter of Examples 3-4 includes, saving, tothe storage device having at least a portion of a patient's anestheticrecord stored thereon, the amount of blood in the waste fluid.

In Example 6, the subject matter of Examples 1-5 includes, whereinoutputting the delta includes wirelessly sending the information to atablet device in a surgical field.

In Example 7, the subject matter of Examples 1-6 includes, outputting,using the processor, an alert to a tablet device in a surgical field,the alert related to the amount of fluid or a measured level of fluid inthe fluid storage device.

In Example 8, the subject matter of Examples 1-7 includes, whereinoutputting the delta includes sending the information to a displaymounted on a housing having a first surgical module and a secondsurgical module stored therein, wherein the first and second surgicalmodules include electrical and electro-mechanical surgical equipment,and wherein the first and second surgical modules support separatesurgical functions.

In Example 9, the subject matter of Examples 1-8 includes, whereinsaving at least a portion of the information includes determining anamount of blood in the waste fluid, and automatically saving informationabout the amount of blood in the waste fluid to the storage devicehaving at least a portion of the patient's anesthetic record storedthereon.

In Example 10, the subject matter of Examples 1-9 includes, wherein theinformation includes a first fluid amount and a second fluid amount, andwherein determining the delta includes determining a rate of changebetween the first fluid amount measured at the first time and the secondfluid amount measured at the second time, and outputting the rate ofchange, using the processor, to display the delta on the electronicdevice.

In Example 11, the subject matter of Examples 1-10 includes, activating,with the processor, a stirrer located proximate the fluid storage deviceto agitate and mix the waste fluid in the fluid storage device, whereinthe stirrer is coupled to a housing including a substantiallyheat-confining cowling, the housing having a first surgical module and asecond surgical module stored therein, wherein the first and secondsurgical modules include electrical and electro-mechanical surgicalequipment, and wherein the first and second surgical modules supportdifferent surgical functions.

In Example 12, the subject matter of Examples 1-11 includes, activating,with the processor, a vacuum pump to induce a negative air pressure onan inside of a fluid suction bag disposed in the fluid storage device.

In Example 13, the subject matter of Examples 1-12 includes,determining, with the processor, that a level of fluid in the fluidstorage device has traversed a threshold; and activating, with theprocessor, a vacuum valve to a to shift a flow of waste fluid from thefluid storage device to a second fluid storage device.

Example 14 is at least one non-transitory machine-readable mediumincluding instructions for monitoring waste fluid during a surgery,which when executed by processing circuitry, cause the processingcircuitry to perform operations comprising: receiving information aboutan amount of a waste fluid collected in a waste fluid storage device,from a sensor, wherein the information includes, a first fluid amountmeasured at a first time and a second fluid amount measured at a secondtime; determining, a delta between the first fluid amount and the secondfluid amount, using the information; outputting the delta, to displaythe delta on an electronic device, wherein the electronic device iscoupled to a housing configured to store unrelated waste-heat producingelectronic and electromechanical surgical equipment; and saving at leasta portion of the information, to a storage device having at least aportion of a patient's anesthetic record stored thereon.

In Example 15, the subject matter of Example 14 includes, wherein theamount of waste fluid is a weight of the waste fluid.

In Example 16, the subject matter of Examples 14-15 includes, theoperations further comprising: receiving information about a volume ofblood in the waste fluid storage device, from a second sensor; receivinginformation about a concentration of a blood characteristic in the wastefluid, from a third sensor; receiving information about a concentrationof a blood characteristic in the patient prior to the surgery from amemory, using the processor; determining an amount of blood in the wastefluid, wherein determining the amount of blood in the waste fluid isdetermined by dividing the information about a concentration of a bloodcharacteristic in the waste fluid by the information about aconcentration of a blood characteristic in a patient prior to thesurgery to establish a concentration ratio, and multiplying theconcentration ratio by the information about a volume of blood in thewaste fluid storage device; and outputting the amount of blood in thewaste fluid, using the processor, to display the amount of blood in thewaste fluid on the electronic device.

In Example 17, the subject matter of Example 16 includes, wherein theinformation about the volume of blood in the waste fluid storage deviceincludes a correction to ignore a volume of foam in the waste fluidstorage device.

In Example 18, the subject matter of Examples 16-17 includes, theoperations further comprising: saving, to the storage device having atleast a portion of a patient's anesthetic record stored thereon, theamount of blood in the waste fluid.

In Example 19, the subject matter of Examples 14-18 includes, whereinoutputting the delta includes wirelessly sending the information to atablet device in a surgical field.

In Example 20, the subject matter of Examples 14-19 includes, theoperations further comprising: outputting, using the processor, an alertto a tablet device in a surgical field, the alert related to the amountof fluid or a measured level of fluid in the fluid storage device.

In Example 21, the subject matter of Examples 14-20 includes, whereinoutputting the delta includes sending the information to a displaymounted on a housing having a first surgical module and a secondsurgical module stored therein, wherein the first and second surgicalmodules include electrical and electro-mechanical surgical equipment,and wherein the first and second surgical modules support separatesurgical functions.

In Example 22, the subject matter of Examples 14-21 includes, whereinsaving at least a portion of the information includes determining anamount of blood in the waste fluid, and automatically saving informationabout the amount of blood in the waste fluid to the storage devicehaving at least a portion of the patient's anesthetic record storedthereon.

In Example 23, the subject matter of Examples 14-22 includes, whereinthe information includes a first fluid amount and a second fluid amount,and wherein determining the delta includes determining a rate of changebetween the first fluid amount measured at the first time and the secondfluid amount measured at the second time, and outputting the rate ofchange, using the processor, to display the delta on the electronicdevice.

In Example 24, the subject matter of Examples 14-23 includes, theoperations further comprising: sending instructions to activate astirrer located proximate the fluid storage device to agitate and mixthe waste fluid in the fluid storage device, wherein the stirrer iscoupled to a housing including a substantially heat-confining cowling,the housing having a first surgical module and a second surgical modulestored therein, wherein the first and second surgical modules includeelectrical and electro-mechanical surgical equipment, and wherein thefirst and second surgical modules support different surgical functions.

In Example 25, the subject matter of Examples 14-24 includes, theoperations further comprising: sending instructions to activate a vacuumpump to induce a negative air pressure on an inside of a fluid suctionbag disposed in the fluid storage device.

In Example 26, the subject matter of Examples 14-25 includes, theoperations further comprising: determining, with the processor, that alevel of fluid in the fluid storage device has traversed a threshold;and activating, with the processor, a vacuum valve to a to shift a flowof waste fluid from the fluid storage device to a second fluid storagedevice.

Example 27 is at least one machine-readable medium includinginstructions that, when executed by processing circuitry, cause theprocessing circuitry to perform operations to implement of any ofExamples 1-26.

Example 28 is an apparatus comprising means to implement of any ofExamples 1-26.

Example 29 is a system to implement of any of Examples 1-26.

Example 30 is a method to implement of any of Examples 1-26.

Example Set 4

Example 1 is a method comprising: receiving an instruction, usingcircuitry, to secure a surgical module to a floor; applying a vacuum toa suction cup, using the circuitry, wherein the vacuum is provided by avacuum pump operably coupled to the suction cup, and wherein the suctioncup is located under the surgical module, and wherein applying thevacuum to the suction cup causes the suction cup to create a suctioncoupling with the floor.

In Example 2, the subject matter of Example 1 includes, wherein thevacuum is a continuous vacuum.

In Example 3, the subject matter of Examples 1-2 includes, wherein thevacuum pump is disposed within a housing of the surgical module.

In Example 4, the subject matter of Examples 1-3 includes, wherein thevacuum pump is a hospital vacuum source.

In Example 5, the subject matter of Examples 1-4 includes, receiving,using the circuitry, an instruction to decouple the surgical module fromthe floor; and actuating, using the circuitry, a lifting element torelease the vacuum applied to the suction cup to decouple the surgicalmodule from the floor.

In Example 6, the subject matter of Examples 1-5 includes, receiving,using the circuitry, an instruction to apply a vacuum to a waste fluidstorage device; and applying, using the circuitry, a vacuum to the wastefluid storage device, wherein the vacuum is provided by the vacuum pump.

Example 7 is at least one non-transitory machine-readable mediumincluding instructions for securing a surgical module to a floor, whichwhen executed by circuitry, cause the circuitry to perform operationscomprising: receiving an instruction to secure a surgical module to afloor; applying a vacuum to a suction cup, wherein the vacuum isprovided by a vacuum pump operably coupled to the suction cup, andwherein the suction cup is located under the surgical module, andwherein applying the vacuum to the suction cup causes the suction cup tocreate a suction coupling with the floor.

In Example 8, the subject matter of Examples 6-7 includes, wherein thevacuum is a continuous vacuum.

In Example 9, the subject matter of Examples 6-8 includes, wherein thevacuum pump is disposed within a housing of the surgical module.

In Example 10, the subject matter of Examples 6-9 includes, wherein thevacuum pump is a hospital vacuum source.

In Example 11, the subject matter of Examples 6-10 includes, wherein thecircuitry further performs operations to: receive an instruction todecouple the surgical module from the floor; and actuate a liftingelement to release the vacuum applied to the suction cup to decouple thesurgical module from the floor.

In Example 12, the subject matter of Examples 6-11 includes, wherein thecircuitry further performs operations to receive an instruction to applya vacuum to a waste fluid storage device; and apply a vacuum to thewaste fluid storage device, wherein the vacuum is provided by the vacuumpump.

Example 13 is at least one machine-readable medium includinginstructions that, when executed by processing circuitry, cause theprocessing circuitry to perform operations to implement of any ofExamples 1-12.

Example 14 is an apparatus comprising means to implement of any ofExamples 1-12.

Example 15 is a system to implement of any of Examples 1-12.

Example 16 is a method to implement of any of Examples 1-12.

Example Set 5

Example 1 is a method for measuring urine output from a catheterizedpatient, the method comprising: receiving from a sensor, usingcircuitry, information corresponding to at least a weight of urinecollected in a urine bag at a first time and a second weight of urinecollected in the urine bag at a second time, wherein the sensor isoperably coupled to a urine bag hanger configured to receive the urinebag, and wherein the urine bag hanger is coupled to a housing;determining, using the circuitry and the information, a volume of urinethat corresponds to the weight of urine collected between the first timeand the second time; saving, using the circuitry, to a storage devicehaving at least a portion of a patient's anesthetic record storedthereon, a volume of urine output collected in the urine bag between thefirst time and the second time.

In Example 2, the subject matter of Example 1 includes, wherein thesensor is an electronic scale sensor.

In Example 3, the subject matter of Examples 1-2 includes, wherein thecircuitry includes a processor.

In Example 4, the subject matter of Examples 1-3 includes, determining,using the circuitry and the information, a delta or rate of urinecollected between the first time and the second time, and outputting thedelta or rate, using the circuitry, to display the delta or rate ofurine collected on an electronic device, wherein the electronic deviceis coupled to a housing configured to store unrelated waste-heatproducing electronic and electromechanical surgical equipment.

In Example 5, the subject matter of Examples 1-4 includes, sensing, withthe sensor, when the urine bag is initially placed on the urine baghanger; and zeroing the first weight, using the circuitry, when thesensor senses that the urine bag is initially placed on the urine baghanger to establish a start point for measuring the collection of urine.

Example 6 is at least one non-transitory machine-readable mediumincluding instructions for performing operations to measure urine outputfrom a catheterized patient, the method comprising: receivinginformation corresponding to at least a weight of urine collected in aurine bag at a first time and a second weight of urine collected in theurine bag at a second time using a sensor, wherein the sensor isoperably coupled to a urine bag hanger configured to receive the urinebag, and wherein the urine bag hanger is coupled to a housing;determining, using the information, a volume of urine that correspondsto the weight of urine collected between the first time and the secondtime; saving to a storage device having at least a portion of apatient's anesthetic record stored thereon, a volume of urine outputcollected in the urine bag between the first time and the second time.

In Example 7, the subject matter of Example 6 includes, wherein thesensor is an electronic scale sensor.

In Example 8, the subject matter of Examples 6-7 includes, wherein thecircuitry includes a processor.

In Example 9, the subject matter of Examples 6-8 includes, theoperations further comprising: determining, using the information, adelta or rate of urine collected between the first time and the secondtime, and outputting the delta or rate to display the delta or rate ofurine collected on an electronic device, wherein the electronic deviceis coupled to a housing configured to store unrelated waste-heatproducing electronic and electromechanical surgical equipment.

In Example 10, the subject matter of Examples 6-9 includes, theoperations further comprising: sensing, with the sensor, when the urinebag is initially placed on the urine bag hanger; and zeroing the firstweight when the sensor senses that the urine bag is initially placed onthe urine bag hanger to establish a start point for measuring thecollection of urine.

Example 11 is at least one machine-readable medium includinginstructions that, when executed by processing circuitry, cause theprocessing circuitry to perform operations to implement of any ofExamples 1-10.

Example 12 is an apparatus comprising means to implement of any ofExamples 1-10.

Example 13 is a system to implement of any of Examples 1-10.

Example 14 is a method to implement of any of Examples 1-10.

Example Set 6

Example 1 is a method comprising: receiving an instruction, usingprocessing circuitry, to provide air to at least one of a surgical airmattress or a surgical body compression device; sending an instruction,using the processing circuitry, to an air pump, causing air to beprovided to at least one of the surgical air mattress or the surgicalbody compression device, wherein the air pump is disposed within ahousing, and wherein the housing is configured to house a first surgicalmodule and a second surgical module comprising unrelated wasteheat-producing electronic and electromechanical surgical equipment.

In Example 2, the subject matter of Example 1 includes, receiving aninstruction, using the processing circuitry, to activate a fan disposedwithin the housing; actuating the fan, using the processing circuitry,wherein actuating the fan causes an airflow to be received into an inletvent of the housing, the airflow to be passed through an air cleaningdevice, and the airflow along with waste heat produced by the electronicand electromechanical surgical equipment to be exhausted through anoutlet vent.

In Example 3, the subject matter of Example 2 includes, receivinginformation from a sensor, using the processing circuitry, theinformation indicating a sensed condition of the surgical air mattressor the surgical body compression device; and determining, using theprocessing circuitry, if the sensed condition has traversed a threshold,and if the sensed condition has traversed the threshold, actuating,using the processing circuitry, a flow managing device to divert atleast a portion of the airflow to the surgical air mattress or thesurgical body compression device to supplement the air provided by theair pump, based on the information received from the sensor.

In Example 4, the subject matter of Examples 2-3 includes, receiving aninstruction, using the processing circuitry, to activate a noisecancellation device configured to cancel at least a portion of a noisegenerated by the fan or the air pump.

Example 5 is at least one non-transitory machine-readable mediumincluding instructions for supplying air to a surgical air mattress or asurgical body compression device, which when executed by processingcircuitry, cause the processing circuitry to perform operationscomprising: receive an instruction to provide air to at least one of asurgical air mattress or a surgical body compression device; send aninstruction, using the processing circuitry, to an air pump, to provideair to at least one of the surgical air mattress or the surgical bodycompression device, wherein the air pump is disposed within a housing,and wherein the housing is configured to house a first surgical moduleand a second surgical module comprising unrelated waste heat-producingelectronic and electromechanical surgical equipment.

In Example 6, the subject matter of Example 5 includes, wherein theinstructions further cause the processing circuitry to: receive aninstruction to activate a fan disposed within the housing; activate thefan based on the instruction to activate the fan, wherein activating thefan causes an airflow to be received into an inlet vent of the housing,the airflow to be passed through an air cleaning device, and the airflowalong with waste heat produced by the electronic and electromechanicalsurgical equipment to be exhausted through an outlet vent.

In Example 7, the subject matter of Example 6 includes, wherein theinstructions further cause the processing circuitry to: receiveinformation from a sensor indicating a second sensed condition of thesurgical air mattress or the surgical body compression device; anddetermine if the second sensed condition has traversed a threshold, andif the second sensed condition has traversed the threshold, actuating aflow managing device to divert at least a portion of the airflow to thesurgical air mattress or the surgical body compression device tosupplement the air provided by the air pump, based on the informationreceived from the sensor.

In Example 8, the subject matter of Examples 6-7 includes, wherein theinstructions further cause the processing circuitry to: receive aninstruction to activate a noise cancellation device configured to cancelat least a portion of a noise generated by the fan or the air pump.

Example 9 is at least one machine-readable medium including instructionsthat, when executed by processing circuitry, cause the processingcircuitry to perform operations to implement of any of Examples 1-8.

Example 10 is an apparatus comprising means to implement of any ofExamples 1-8.

Example 11 is a system to implement of any of Examples 1-8.

Example 12 is a method to implement of any of Examples 1-8.

Example Set 7

Example 1 is a method for filtering air in a surgical field, the methodcomprising: providing or receiving, into a housing having aheat-resistant cowling, a first surgical module; providing or receiving,into the housing, a second surgical module, wherein the first surgicalmodule and the second surgical module are unrelated waste heat-producingelectronic and electromechanical surgical equipment; containing,substantially within the housing, the waste heat generated by the firstsurgical module and the second surgical module; receiving aninstruction, using circuitry, to activate a fan disposed within thehousing; actuating the fan, using the circuitry, to create an airflow;receiving the airflow through an inlet vent and into a plenum, whereinthe plenum includes, a plenum wall separating the first surgical moduleand the second surgical module from the plenum; passing the airflowthrough a filter, to remove infectious particles generated during asurgery; blowing at least a portion of the airflow through a vent tube;and exhausting, through an outlet vent, at least a portion of theairflow and at least a portion of the waste heat.

In Example 2, the subject matter of Example 1 includes, whereinproviding or receiving the first surgical module includes providing orreceiving anesthesia monitoring equipment, and wherein providing orreceiving the second surgical module includes providing or receivingelectrosurgical grounding equipment, and wherein the first surgicalmodule and the second surgical module are cooled by the airflow.

In Example 3, the subject matter of Examples 1-2 includes, whereinreceiving the airflow includes collecting air from a specified locationproximate a head of a patient during a surgery.

In Example 4, the subject matter of Examples 1-3 includes, positioning avacuum hose proximate a head of a patient during a surgery, wherein thevacuum hose is operably couplable to the inlet vent, and whereinreceiving the air includes receiving the air through the vacuum hose.

In Example 5, the subject matter of Examples 1-4 includes, positioning avacuum hose between a patient and a surgeon, wherein the vacuum hose isoperably couplable to the inlet vent, and wherein receiving the airflowincludes receiving the airflow through the vacuum hose.

In Example 6, the subject matter of Examples 1-5 includes, positioning avacuum hose proximate a patient and a surgeon, wherein the vacuum hoseis operably couplable to the inlet vent, and wherein receiving theairflow includes receiving the airflow through the vacuum hose.

In Example 7, the subject matter of Examples 1-6 includes, operablycoupling a vacuum hose to the inlet vent, and positioning the vacuumhose proximate a lateral side body of a patient to evacuate the air froma ventilation dead zone, and wherein receiving the airflow includesreceiving the airflow through the vacuum hose.

In Example 8, the subject matter of Examples 1-7 includes, whereinexhausting the airflow includes exhausting the airflow through theoutlet vent positioned at least four feet above a floor that the housingis positioned on.

In Example 9, the subject matter of Examples 1-8 includes, whereinreceiving the airflow includes collecting air from a specified locationbetween a height of a surgical table and a floor of the surgical fieldduring a surgery, and exhausting the airflow includes exhausting theairflow at least four feet above a floor that the housing is positionedon.

In Example 10, the subject matter of Examples 1-9 includes, inches of asurgical table in a surgical field during a surgery.

In Example 11, the subject matter of Examples 1-10 includes,positioning, under an arm-board of a surgical table and adjacent ananesthesia screen, a lower bulbous portion of the housing.

In Example 12, the subject matter of Examples 1-11 includes,positioning, under an arm-board of a surgical table and adjacent ananesthesia screen, a lower bulbous portion of the housing; andpositioning, adjacent an anesthesia screen, an upper tower-like portionof the housing, the upper tower-like portion including one or moredisplays.

In Example 13, the subject matter of Examples 1-12 includes,positioning, under an arm-board of a surgical table and adjacent ananesthesia screen, a lower bulbous portion of the housing; andpositioning, adjacent an anesthesia screen, an upper tower-like portionof the housing; and receiving the first and second surgical modules intoa lower bulbous portion of the housing.

Example 14 is at least one non-transitory machine-readable mediumincluding instructions for filtering air within a surgical field, whichwhen executed by circuitry, cause the circuitry to perform operationscomprising: cause one or more power sources to provide power to a firstsurgical module stored in an insulated housing, the first surgicalmodule being associated with a first surgical function, and the firstsurgical module producing a first waste heat; cause the one or morepower sources to provide power to a second surgical module stored in thehousing, the second surgical module associated with a second surgicalfunction, and the second surgical module producing a second waste heat,wherein the first surgical module and second surgical module aredirected to different surgical functions; and receive an instruction toactivate a fan disposed in the housing; activate the fan, whereinactuating the fan causes air to be collected from a specified locationand to deliver an airflow to the housing causing the airflow to passthrough a filter to remove infectious particles associated with thesurgical field, and to pass at least a portion of the airflow through avent tube, and to exhaust at least a portion of the airflow and at leasta portion of the first and second waste heat through an outlet vent.

In Example 15, the subject matter of Example 14 includes, wherein thecircuitry further performs operations to: receive an instruction toactivate a noise cancellation device configured to cancel at least aportion of a noise generated by the fan.

In Example 16, the subject matter of Examples 14-15 includes, whereincausing the one or more power sources to power the first surgical moduleincludes powering an anesthesia monitor.

In Example 17, the subject matter of Examples 14-16 includes, wherein tocause the one or more power sources to power the second surgical moduleincludes powering an electrosurgical generator.

In Example 18, the subject matter of Examples 14-17 includes, wherein tocause the one or more power sources to power the first and secondsurgical modules includes powering an anesthesia monitor and powering anelectrosurgical generator.

In Example 19, the subject matter of Examples 14-18 includes, wherein toactivate the fan includes activating the fan positioned and configuredto collect the air from a specified location proximate a head of apatient during a surgery.

In Example 20, the subject matter of Examples 14-19 includes, wherein toactivate the fan includes activating the fan positioned and configuredto evacuate the air from a ventilation dead zone proximate a lateralside body of a patient.

In Example 21, the subject matter of Examples 14-20 includes, wherein toactivate the fan includes activating a fan positioned and configured toexhaust at least a portion of the airflow at least four feet above afloor that the housing is positioned on.

In Example 22, the subject matter of Examples 14-21 includes, wherein toactivate the fan causes air to be collected from a location at or belowthe height of the surgical table in a surgical field during a surgery,and wherein to exhaust the air from the housing, includes exhausting theair at least five feet above the floor that the housing is positionedon.

In Example 23, the subject matter of Example 22 includes, wherein toactivate the fan causes air to be collected at a location between anunderside of a surgical table and a floor that the surgical table ispositioned above.

In Example 24, the subject matter of Examples 14-23 includes, whereinthe housing substantially confines the waste heat produced by the firstand second surgical modules.

Example 25 is at least one machine-readable medium includinginstructions that, when executed by processing circuitry, cause theprocessing circuitry to perform operations to implement of any ofExamples 1-24.

Example 26 is an apparatus comprising means to implement of any ofExamples 1-24.

Example 27 is a system to implement of any of Examples 1-24.

Example 28 is a method to implement of any of Examples 1-24.

Example Set 8

In an example 1, a module for housing unrelated electronic andelectromechanical equipment for use during surgery including anultraviolet operating room disinfection system, the module comprising:

-   -   a lower section for housing unrelated electronic and        electromechanical equipment;    -   a tower-like upper section located on top of the lower section;    -   the top of the tower-like upper section terminates at least 5        feet above the floor;    -   a water-resistant cowling enclosing at least a portion of the        lower section and the tower-like upper section; and    -   a cartridge containing one or more ultraviolet-C producing        lights that is protectively housed within the tower-like upper        section;    -   the cartridge containing one or more ultraviolet-C producing        lights that emerges upward from the top of the tower-like upper        section to substantially seat itself on the top of the        tower-like upper section when activated;    -   wherein the elevated location on top of the tower-like upper        section allows the ultraviolet-C light to disinfect the patient        and staff-contacting upper surfaces of the equipment in the        operating room.

1a. The module of any preceding example, wherein the one or moreultraviolet-C producing lights in the cartridge containing the one ormore ultraviolet-C producing lights are arranged to projectultraviolet-C light in the full 360o surrounding the module.

1b. The module of any preceding example, wherein one or more of theultraviolet-C producing lights in the cartridge containing the one ormore ultraviolet-C producing lights are oriented to shine on the moduleand thus disinfect it by pivoting to an angle that extends the one ormore lights outward from the sides of the tower-like upper section whenactivated.

1c. The module of any preceding example, wherein at least four of theultraviolet-C producing lights are oriented to shine on the module andthus disinfect it by pivoting to a partially horizontal angle thatextends the four or more lights outward from the tower-like uppersection when activated allowing them to shine directly on all sides ofthe module.

1d. The module of any preceding example, wherein at least fourultraviolet-C producing lights are mounted in the four corners of thelower section near the floor and are oriented to shine on the floor andundersides of the equipment in the operating room.

1e. The module of any preceding example, wherein the lower section has abulbous form configured to allow that the rear portion of the tower-likeupper section to be positioned adjacent the anesthesia side of one ofthe arm-boards of the surgical table with the bulbous lower sectionfitting into the unused space under the arm board.

In an example 2, a module for housing unrelated electronic andelectromechanical equipment for use during surgery including a wasteblood and fluid suction system, the module comprising:

-   -   a lower section for housing unrelated electronic and        electromechanical equipment;    -   a tower-like upper section located on top of the lower section;    -   a water-resistant cowling enclosing at least a portion of the        lower section and the tower-like upper section; and    -   one or more bucket-like recesses in or on the cowling of the        lower section for mounting one or more fluid suction canisters;    -   the fluid suction canisters mounted on the one or more        bucket-like recesses are operably connected to a vacuum source        controlled from within the module;    -   wherein the bucket-like recesses for mounting one or more fluid        suction canisters also include one or more electronic scales for        measuring the combined weight of each fluid suction canister and        its blood and fluid contents.

2a. The module of any preceding example, wherein the one or moreelectronic scales for measuring the combined weight of each fluidsuction canister and its blood and fluid contents allow an accuratecalculation of the volume of the blood and fluid in the one or morecanisters while omitting the false volume produced by air bubbles andfoam.

2b. The module of any preceding example, wherein the bucket-likerecesses for mounting one or more fluid suction canisters also includeone or more optical or infrared fluid level sensors for sensing thecombined volume of blood, fluid, air bubbles and foam in the canister.

2c. The module of any preceding example, wherein the optical or infraredfluid level sensors for sensing the combined volume of blood, fluid, airbubbles and foam in the one or more canisters are operably connected tothe vacuum source controlled from within the module and canautomatically stop the vacuum applied to any canister that that has beenfilled to its useful capacity.

2d. The module of any preceding example, wherein the bucket-likerecesses for mounting one or more fluid suction canisters also includeone or more optical or infrared sensors for determining the hematocritof the blood and fluid in the canister.

2e. The module of any preceding example, wherein the output of the oneor more optical or infrared sensors for determining the hematocrit ofthe blood and fluid in the canister plus the measurement of the volumeof blood and fluid in the canister as determined by weight is inputtedto a microprocessor in the module to calculate blood loss.

2f. The module of any preceding example, wherein the lower section has abulbous form configured to allow that the rear portion of the tower-likeupper section to be positioned adjacent the anesthesia side of one ofthe arm-boards of the surgical table with the bulbous lower sectionfitting into the unused space under the arm board.

In an example 3, a module for housing unrelated electronic andelectromechanical equipment for use during surgery and providing amounting location for equipment accessing the surgical field, the modulecomprising:

-   -   a bulbous lower section for housing unrelated electronic and        electromechanical equipment;    -   at least a portion of the bulbous lower section fits into an        unused space under the arm-board of a surgical table;    -   a tower-like upper section located on top of the lower section;    -   the tower-like upper section is taller than the height of the        anesthesia screen;    -   a water-resistant cowling enclosing at least a portion of the        lower section and the tower-like upper section;    -   wherein the tower-like upper section can be positioned adjacent        the anesthesia side of an arm-board of a surgical table adjacent        the anesthesia screen, and the rear side of the tower-like upper        section that is facing the surgical field can be used for        mounting various pieces of surgical equipment that need direct        access to the surgical field from the head end.

3a. The module of any preceding example, wherein the upper portion ofthe tower-like upper section that is facing the surgical field can beused for mounting monitor screens such as patient vital sign monitorscreens, surgical scope monitor screens, surgical check list monitorscreens, safety check list monitor screens, communications and messagemonitor screens, clocks and timing device screens.

3b. The module of any preceding example, wherein the upper portion ofthe tower-like upper section that is facing the surgical field can beused for mounting surgical lights aiming at the surgical field.

3c. The module of any preceding example, wherein the upper portion ofthe tower-like upper section that is facing the surgical field can beused for mounting articulating arms that can “reach” across the upperedge of the anesthesia screen, into the sterile surgical field and holdsurgical lights, surgical instruments, surgical scopes or surgicalretractors.

3d. The module of any preceding example, wherein the upper portion ofthe tower-like upper section that is facing the surgical field can beused for mounting one or more video cameras for recording the surgicalprocedure.

3e. The module of any preceding example, wherein the upper portion ofthe tower-like upper section that is facing the surgical field can beused for mounting a sterile storage container for surgical supplies.

In an example 4, a module for housing unrelated electronic andelectromechanical equipment for use during surgery including suctioncups for anchoring the module to the floor, the module comprising:

-   -   a lower section for housing unrelated electronic and        electromechanical equipment;    -   a tower-like upper section located on top of the lower section;    -   a water-resistant cowling enclosing at least a portion of the        lower section and the tower-like upper section; and    -   one or more suction cups on the underside of the lower section        that may be lowered to engage with the floor,    -   wherein a suction anchor for stabilizing the module is created        when the one or more suction cups are lowered to engage with the        floor and a vacuum from a vacuum source controlled in the module        is applied to the inside of the suction cups.

4a. The module of any preceding example, wherein the vacuum source isthe hospital vacuum supplied to the module.

4b. The module of any preceding example, wherein the vacuum source is avacuum pump housed within the module.

4c. The module of any preceding example, wherein the one or more suctioncups are lowered by pneumatic cylinder actuators to engage with thefloor.

4d. The module of any preceding example, wherein the one or more suctioncups are lowered by electromechanical actuators to engage with thefloor.

4e. The module of any preceding example, wherein the one or more suctioncups are lowered by manual actuators to engage with the floor.

In an example 5, a surgical field ventilation optimization systempowered by a waste air management system housed in a module, thesurgical field ventilation optimization system comprising:

-   -   one or more sterile hoses that are placed in the sterile        surgical field with their distal ends located on top of the        surgical drape substantially in the space between the surgical        wound and the surgeon, where the ventilation flow boundary layer        dead zone that naturally forms in front of the surgeon is        located;    -   the distal ends of the one or more hoses include one or more        holes in the hoses that allow 5-50 CFM of airflow;    -   the proximal ends of the one or more sterile hoses are attached        to a vacuum source;    -   wherein, a vacuum is applied to the proximal end of the one or        more sterile hoses causing air to enter the distal ends of the        hoses evacuating and effectively deflating the flow boundary        layer dead zone that naturally forms in front of the surgeon.

5a. The surgical field ventilation optimization system of any precedingexample, wherein the vacuum source is a waste air management systemhoused in a module.

5b. The surgical field ventilation optimization system of any precedingexample, wherein the vacuum source is a waste air management systemhoused in a module for housing unrelated electronic andelectromechanical equipment during surgery.

5c. The surgical field ventilation optimization system of any precedingexample, wherein the distal ends of the one or more hoses are adhesivelyattached to the sterile drape.

5d. The surgical field ventilation optimization system of any precedingexample, wherein the proximal ends of the one or more hoses may becombined in order to reduce the number of hoses being attached to thevacuum source.

5e. The surgical field ventilation optimization system of any precedingexample, wherein evacuating and deflating the flow boundary layer deadzone that naturally forms in front of the surgeon results in theventilation airflow remaining unimpeded which keeps the airbornecontaminating particles airborne, thus preventing them from settlinginto the open wound.

Example Set 9

Example 1 is a module for housing unrelated electronic andelectromechanical surgical equipment including a system to measure andrecord administration of one or more IV medications or fluids for IVadministration, the module comprising: a housing having a lower sectionand a tower-like upper section, wherein the lower section is configuredto house unrelated waste heat-producing electronic and electromechanicalsurgical equipment, and wherein the tower-like upper section is locatedon top of the lower section, wherein the upper section is configured toaccommodate mounting of equipment controls, display screens and monitorscreens at a convenient height for viewing and operating; a cowling thatsubstantially confines waste heat generated by the unrelated wasteheat-producing electronic and electromechanical surgical equipment; anda system for measuring and recording the administration of the one ormore IV medications and fluids, the system comprising: a barcode readeror an RFID interrogator configured to identify at least one of the oneor more IV medications or fluids; and a machine vision digital camera inelectrical communication with processing circuitry configured todetermine a volume of medication administered from a syringe or fluidadministered from an IV bag through an IV drip chamber into an IV tubingbased on an image generated by the machine vision digital camera.

In Example 2, the subject matter of Example 1 includes, the system tomeasure and record the administration of the one or more IV medicationsor fluids further comprising: an injection portal; and one or moreorienting members, wherein the injection portal includes an injectionport that is configured to be in fluid communication with the IV tubingand the one or more orienting members are configured to guide syringesof varying diameters to mate with the injection port within theinjection portal.

In Example 3, the subject matter of Example 2 includes, wherein thesystem to measure and record the administration of the one or more IVmedications or fluids further comprises: a display in electricalcommunication with the machine vision digital camera, wherein themachine vision digital camera is configured to capture an image of asyringe when the syringe is inserted inside the injection portal, andwherein the display is configured to output a visual image orrepresentation of the syringe.

In Example 4, the subject matter of Examples 2-3 includes, wherein themachine vision digital camera is located to capture an image of aninside of the injection portal, and wherein the processing circuitry isconfigured to interpret the image of a syringe when the syringe isinserted into the injection portal to measure the volume of medicationinjected from the syringe by determining a size and an internal diameterof the syringe and measuring a distance a plunger of the syringe movesto calculate an injected volume.

In Example 5, the subject matter of Examples 1-4 includes, wherein theRFID interrogator is configured to identify at least one of the one ormore IV medications or fluids for IV administration that has beenlabeled with an RFID tag.

In Example 6, the subject matter of Examples 1-5 includes, wherein themachine vision digital camera that is in electrical communication withthe processing circuitry is configured to read a barcode to identify amedication or fluid for IV administration that has been labeled with abarcode.

In Example 7, the subject matter of Examples 1-6 includes, wherein thesystem to measure and record the administration of the one or more IVmedications or fluids further comprises: a display in electricalcommunication with the machine vision digital camera, wherein thedisplay is configured to output medication and fluid identification andinjection information including one or more of: a brand name of a drug,a generic name of a drug, a concentration of a drug, a dosage of a drug,a dosage delivered, a fluid flow rate, a fluid volume delivered, apatient allergy, an alert for over-dosing, an alert for a drug allergyand an alert for drug interactions on the display.

In Example 8, the subject matter of Example 7 includes, wherein thesystem to measure and record the administration of the one or more IVmedications or fluids further comprises or is in electricalcommunication with one or more of: an electronic anesthetic record (EAR)and an electronic medical record (EMR), and wherein the systemautomatically records at least some of the administration of the one ormore IV medications in one or both of the (EAR) and the (EMR).

In Example 9, the subject matter of Examples 2-8 includes, wherein thesystem to measure and record the administration of the one or more IVmedications or fluids further comprises: a mechanical clamp configuredto clamp the IV tubing, the mechanical clamp positioned upstream ordownstream from the injection port, wherein the mechanical clamp can beautomatically actuated to mechanically compress the IV tubing to stopthe administration of the one or more IV medications or fluids when anadverse condition is determined by the processing circuitry.

In Example 10, the subject matter of Examples 2-9 includes, wherein theinjection portal includes one or more UV lights that shine on theinjection port.

In Example 11, the subject matter of Examples 1-10 includes, wherein themachine vision digital camera is located adjacent to the IV dripchamber, and wherein the processing circuitry is configured to interpretthe image of drops in the IV drip chamber and determine a volume offluid flowing from the IV bag by determining a size of drops and anumber of drops per unit time to calculate a fluid flow rate.

In Example 12, the subject matter of Examples 1-11 includes, wherein thesystem to measure and record the administration of the one or more IVmedications or fluids further comprises: a hanger configured to supportan IV bag; and an electronic scale in electrical communication with aprocessor, wherein the electronic scale is configured to measure acombined weight of the IV bag, the IV drip chamber, the IV tubing andthe fluids in the IV bag, and wherein the processor is configured todetermine a reduction in the measured combined weight over time todetermine the weight of the IV fluids infused over time and convert themeasured combined weight over time to a fluid flow rate and an infusedfluid volume.

In Example 13, the subject matter of Examples 1-12 includes, wherein thesystem to measure and record the administration of the one or more IVmedications or fluids further comprises: a hanger configured to receivethe IV bag; an electronic scale in electrical communication with aprocessor, wherein the hanger is configured to support the IV bag; and afloat located in the IV drip chamber, wherein the machine vision digitalcamera is located adjacent to the IV drip chamber, and wherein theprocessing circuitry is configured to determine a volume of fluidflowing from the IV bag by determining a size of drops and a number ofthe drops per unit time to calculate a fluid flow rate, wherein theelectronic scale is configured to measure a combined weight of the IVbag, the IV drip chamber, the IV tubing and the fluid in the IV bag, andwherein the processing circuitry is configured to determine a reductionin the measured combined weight over time to determine a weight of theIV fluids infused over time and convert the measured combined weightover time to a fluid flow rate and infused fluid volume, wherein athigher flow rates, when the drops in the IV drip chamber coalesce into afluid stream that is un-interpretable by the machine vision camera andprocessing circuitry, the fluid stream causes a float in the IV dripchamber to move indicating that fluid is flowing, and wherein when thesystem fails to identify individual drops and detects that the float ismoving, the processing circuitry is configured to measure a fluid flowrate by determining a reduction of the combined weight of the IV bag,the IV drip chamber, the IV tubing and the fluid in the IV bag overtime.

In Example 14, the subject matter of Examples 1-13 includes, wherein thesystem to measure and record the administration of the one or more IVmedications or fluids further comprises: one or more electro-mechanicalclamps in electrical communication with the processing circuitry,wherein the machine vision digital camera is located adjacent the IVdrip chamber that is configured to be connected to the IV bag, whereinthe processing circuitry is configured to interpret the image includinga fluid meniscus level in the IV drip chamber, and wherein when thefluid meniscus is not present, the processing circuitry causes actuationof the one or more electro-mechanical clamps to compress the IV tubingto stop a portion of an IV infusion before air can enter the IV tubing.

Example 15 is a module for housing unrelated electronic andelectromechanical surgical equipment including a system to measure andrecord administration of one or more IV medications or fluids for IVadministration to a patient, the module comprising: a housing having alower section and a tower-like upper section, wherein the lower sectionis configured to house unrelated waste heat-producing electronic andelectromechanical surgical equipment, and wherein the tower-like uppersection is located on top of the lower section, wherein the uppersection is configured to accommodate mounting of equipment controls,display screens and monitor screens at a convenient height for viewingand operating; a cable and hose management system located on a patientside of the module, wherein the patient side of the module is configuredto face a patient and provide the closest and most direct access to thepatient when the module is positioned adjacent an anesthesia side of anarm-board of a surgical table; and a system to measure and record theadministration of the one or more IV medications and fluids, the systemcomprising: a barcode reader or an RFID interrogator configured toidentify at least one of the one or more IV medications or fluids; and amachine vision digital camera in electrical communication withprocessing circuitry configured to determine a volume of medicationadministered from a syringe or fluid administered from an IV bag throughan IV drip chamber into an IV tubing based on an image generated by themachine vision digital camera.

In Example 16, the subject matter of Example 15 includes, wherein thesystem to measure and record the administration of the one or more IVmedications or fluids further comprises: an injection portal; and one ormore orienting members, wherein the injection portal includes aninjection port that is configured to be in fluid communication with theIV tubing and the one or more orienting members are configured to guidesyringes of varying diameters to mate with the injection port within theinjection portal.

In Example 17, the subject matter of Example 16 includes, wherein thesystem to measure and record the administration of the one or more IVmedications or fluids further comprises: a display in electricalcommunication with the machine vision digital camera, wherein themachine vision digital camera is configured to capture an image of thesyringe when the syringe is inserted inside the injection portal, andwherein the display is configured to output a visual image orrepresentation of the syringe.

In Example 18, the subject matter of Examples 16-17 includes, whereinthe machine vision digital camera is located to capture an image of aninside of the injection portal, and wherein the processing circuitry isconfigured to interpret the image of the syringe when the syringe isinserted into the injection portal to measure the volume of medicationinjected from the syringe by determining a size and an internal diameterof the syringe and measuring a distance a plunger of the syringe movesto calculate an injected volume.

In Example 19, the subject matter of Examples 15-18 includes, whereinthe RFID interrogator is configured to identify at least one of the oneor more IV medications or fluids for IV administration that has beenlabeled with an RFID tag.

In Example 20, the subject matter of Examples 15-19 includes, whereinthe machine vision digital camera is in electrical communication withthe processing circuitry is configured to read a barcode to identify amedication or fluid for IV administration that has been labeled with abarcode.

In Example 21, the subject matter of Examples 15-20 includes, whereinthe system to measure and record the administration of the one or moreIV medications or fluids further comprises: a display in electricalcommunication with the machine vision digital camera, wherein thedisplay is configured to output medication and fluid identification andinjection information including one or more of: a brand name of a drug,a generic name of a drug, a concentration of a drug, a dosage of a drug,a dosage delivered, a fluid flow rate, a fluid volume delivered, apatient allergy, an alert for over-dosing, an alert for a drug allergyand an alert for drug interactions on the display.

In Example 22, the subject matter of Example 21 includes, wherein thesystem to measure and record the administration of the one or more IVmedications or fluids further comprises or is in electricalcommunication with one or more of: an electronic anesthetic record (EAR)and an electronic medical record (EMR), and wherein the systemautomatically records at least some of the administration of the one ormore IV medications in one or both of the (EAR) and the (EMR).

In Example 23, the subject matter of Examples 16-22 includes, whereinthe injection portal includes one or more UV lights that shine on theinjection port.

In Example 24, the subject matter of Examples 15-23 includes, whereinthe machine vision digital camera is located adjacent to the IV dripchamber, and wherein the processing circuitry is configured to interpretthe image of drops in the IV drip chamber and determine a volume offluid flowing from the IV bag by determining a size of drops and anumber of drops per unit time to calculate a fluid flow rate.

In Example 25, the subject matter of Examples 15-24 includes, whereinthe system to measure and record the administration of the one or moreIV medications or fluids further comprises: a hanger configured tosupport an IV bag; and an electronic scale in electrical communicationwith a processor, wherein the electronic scale is configured to measurea combined weight of the IV bag, the IV drip chamber, the IV tubing andthe fluids in the IV bag, and wherein the processor is configured todetermine a reduction in the measured combined weight over time todetermine the weight of the IV fluids infused over time and convert themeasured combined weight over time to a fluid flow rate and an infusedfluid volume.

Example 26 is a module comprising: a housing having a lower section anda tower-like upper section, wherein the lower section is configured tohouse unrelated waste heat-producing electronic and electromechanicalsurgical equipment, and wherein the tower-like upper section is locatedon top of the lower section; a cowling that substantially confines wasteheat generated by the unrelated waste heat-producing electronic andelectromechanical surgical equipment; a system for monitoring theadministration of one or more IV medications and fluids, the systemcomprising: a barcode reader or an RFID interrogator configured toidentify the one or more IV medications or fluids; a machine visiondigital camera to capture an image of one or more of a syringe or a dripchamber; processing circuitry operably coupled to the barcode reader orthe RFID interrogator to receive the identity of the one or more IVmedications or fluids, the processing circuitry operably coupled to themachine vision digital camera to receive the captured image anddetermine a volume of medication administered from the syringe or fluidadministered from an IV bag based on the image; and a display operablycoupled to the processing circuitry, the display configured to receiveinstructions from the processing circuitry to output the identity anddetermined volume of medication administered from the syringe or fluidadministered from an IV bag.

Example 27 is at least one machine-readable medium includinginstructions that, when executed by processing circuitry, cause theprocessing circuitry to perform operations to implement of any ofExamples 1-26.

Example 28 is an apparatus comprising means to implement of any ofExamples 1-26.

Example 29 is a system to implement of any of Examples 1-26.

Example 30 is a method to implement of any of Examples 1-26.

What is claimed is:
 1. A module for housing electronic andelectromechanical medical equipment including at least one machinevision digital camera, the module comprising: a housing configured tohouse the electronic and electromechanical medical equipment; a cowlingthat substantially confines the electronic and electromechanical medicalequipment; and at least one machine vision digital camera in electricalcommunication with processing circuitry and software, the processingcircuitry and software configured to document dose events and/orresponse events based on images generated by the at least one machinevision digital camera; wherein each of the at least one machine visiondigital cameras is mounted in a fixed position relative to a medicalequipment item or a patient that is being observed by the at least onemachine vision digital camera, thereby creating a structured scene,based on the images, for the processing circuitry and software toanalyze.
 2. The module of claim 1, wherein the processing circuitry andsoftware is programmed or taught where germane areas are located withinthe structured scene and the processing circuitry and software isprogrammed to focus image identification on the germane areas.
 3. Themodule of claim 2, wherein focusing image identification efforts on thegermane areas of the structured scene increases image identificationspeed.
 4. The module of claim 2, wherein focusing image identificationon the germane areas of the structured scene increases imageidentification accuracy and reliability.
 5. The module of claim 2,wherein at least one machine vision digital camera is positioned todocument delivery of IV medication from a syringe by measuring adistance of movement of a plunger of the syringe, wherein the structuredscene includes an inside of an injection portal including an insertedmedication syringe, and wherein the germane areas of the structuredscene includes a syringe barrel.
 6. The module of claim 2, wherein atleast one machine vision digital camera is positioned to documentdelivery of IV fluids by counting drops in an IV fluid drip chamberwherein the structured scene is a lower portion of a bag of IV fluidsincluding the IV fluid drip chamber and tubing, and wherein the germaneareas of the structured scene includes the IV fluid drip chamber.
 7. Themodule of claim 2, wherein at least one machine vision digital camera ispositioned to document delivery of inhaled anesthetics from ananesthetic vaporizer by measuring a position of a vaporizer dial of theanesthetic vaporizer, wherein the structured scene includes an image ofa worktop area of an anesthesia machine including the anestheticvaporizer, and wherein the germane areas of the structured sceneincludes the vaporizer dial.
 8. The module of claim 2, wherein at leastone machine vision digital camera is positioned to document delivery ofinhaled gases by measuring a height of one or more floats in a tubeventilation gas flow meter, wherein the structured scene includes animage of a control panel of an anesthesia machine including the tubeventilation gas flow meter, controls, and control display screens, andwherein the germane areas of the structured scene includes the tubeventilation gas flow meter.
 9. The module of claim 2, wherein at leastone machine vision digital camera is positioned to document activitiesin a surgical field and a surgical procedure, wherein the structuredscene includes an image of an entirety of the surgical field including asurgeon and assistants, and wherein the germane areas of the structuredscene includes the surgical field.
 10. The module of claim 2, wherein atleast one machine vision digital camera is positioned above a head of apatient in a supine position to document a face of the patient includingskin color, lacrimation, sweating, coughing, salivating, grimacing, orother expressions, wherein the structured scene includes an image of aface, a pillow, a bed, a floor, and a surrounding area, and wherein thegermane areas of the structured scene includes the face of the patient.11. The module of claim 2, wherein at least one machine vision digitalcamera is positioned to observe a patient to document at least onecharacteristic of a patient including skin color, lacrimation, sweating,coughing, salivating, grimacing, expressions, movement, getting out ofbed, or breathing, and wherein the structured scene includes an image ofthe patient, a pillow, a bed, a floor and a surrounding area, andwherein the germane areas of the structured scene includes the patient.12. The module of claim 1, wherein the at least one machine visiondigital camera is in wired or wireless electrical communication withprocessing circuitry and software.
 13. The module of claim 1, whereinthe at least one machine vision digital camera provides images to theprocessing circuitry and software in intermittent timer intervals or ina continuous stream.
 14. A module for housing electronic andelectromechanical medical equipment including at least one machinevision digital camera, the module comprising: a housing configured tohouse the electronic and electromechanical medical equipment; a cable,hose, and IV tubing management system located on a patient side of themodule, wherein the patient side of the module is configured to face apatient and provide direct access to the patient; and at least onemachine vision digital camera in electrical communication withprocessing circuitry and software configured to document dose eventsand/or response events based on images generated by the at least onemachine vision digital camera; wherein each of the at least one machinevision digital cameras is mounted in a fixed position relative to amedical equipment item or the patient that is being observed by at leastone the at least one machine vision digital camera, thereby creating astructured scene, based on the images, for the processing circuitry andsoftware to analyze.
 15. The module of claim 14, wherein the processingcircuitry and software is programmed or taught where a germane area islocated within the structured scene and wherein the processing circuitryand software is programmed to focus image identification on the germanearea.
 16. The module of claim 15, wherein focusing image identificationefforts on the germane area of the structured scene increasesidentification speed.
 17. The module of claim 15, wherein focusing imageidentification efforts on the germane area of the structured sceneincreases identification accuracy and reliability.
 18. The module ofclaim 15, wherein at least one machine vision digital camera ispositioned to document delivery of IV medication from a syringe bymeasuring a distance of movement of a plunger of the syringe, whereinthe structured scene includes an inside of an injection portal includingan inserted medication syringe, and the wherein the germane area of thestructured scene includes a syringe barrel.
 19. The module of claim 15,wherein at least one machine vision digital camera is positioned todocument delivery of IV fluids by counting drops in an IV fluid dripchamber wherein the structured scene is a lower portion of a bag of IVfluids including the IV fluid drip chamber and tubing, and wherein thegermane area of the structured scene include the IV fluid drip chamber.20. The module of claim 15, wherein at least one machine vision digitalcamera is positioned to document delivery of inhaled anesthetics from ananesthetic vaporizer by measuring a position of a vaporizer dial of theanesthetic vaporizer, wherein the structured scene includes an image ofa worktop area of an anesthesia machine including the anestheticvaporizer, and wherein the germane area of the structured scene includesthe vaporizer dial.
 21. The module of claim 15, wherein at least onemachine vision digital camera is positioned to document delivery ofinhaled gases by measuring a height of one or more floats in a tubeventilation gas flow meter, wherein the structured scene includes animage of a control panel of an anesthesia machine including the tubeventilation gas flow meter, knobs, and control display screens, andwherein the germane area of the structured scene includes the tubeventilation gas flow meter.
 22. The module of claim 15, wherein at leastone machine vision digital camera is positioned to document activitiesin a surgical field and a surgical procedure, wherein the structuredscene includes an image of an entirety of the surgical field including asurgeon and assistants, and wherein the germane area of the structuredscene includes the surgical field.
 23. The module of claim 15, whereinat least one machine vision digital camera is positioned above a head ofa patient in a supine position to document a face of the patientincluding skin color, lacrimation, sweating, coughing, salivating,grimacing, or other expressions, wherein the structured scene includesan image of a face, a pillow, a bed, a floor, and a surrounding area,and wherein the germane area of the structured scene includes the faceof the patient.
 24. The module of claim 15, wherein at least one machinevision digital camera is positioned to observe a patient to document atleast one characteristic of a patient including skin color, lacrimation,sweating, coughing, salivating, grimacing, expressions, movement,getting out of bed, or breathing, and wherein the structured sceneincludes an image of the patient, a pillow, a abed, floor and asurrounding area, and wherein the germane area of the structured sceneincludes the patient.
 25. The module of claim 14, wherein the at leastone machine vision digital camera is in wired or wireless electricalcommunication with processing circuitry and software.
 26. The module ofclaim 14, wherein the at least one machine vision digital cameraprovides images in intermittent timer intervals or in a continuousstream to the processing circuitry and software.
 27. A modulecomprising: a housing configured to house electronic andelectromechanical medical equipment; a cowling that substantiallyconfines waste heat generated by the electronic and electromechanicalmedical equipment; and at least one machine vision digital camera inelectrical communication with processing circuitry and softwareconfigured to document dose events and/or response events based onimages generated by the at least one machine vision digital camera;wherein each of the at least one machine vision digital cameras ismounted in a fixed position relative to a medical equipment item or apatient that is observed by the at least one machine vision digitalcamera, thereby creating a structured scene, based on the images, forthe processing circuitry and software to analyze.